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

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 your 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, CFRE
Discovery Eye Foundation

AMD and a Healthy Diet: How they Relate

While there is still no concrete answer as to why some do not develop age-related macular degeneration (AMD) and other’s do, significant studies have proven the importance of a healthy diet and the mitochondria.

AMD is the leading cause of vision loss for those over 60 years of age in the developing countries. For decades we have studies that show the genetics and environmental factors associated with AMD. There have been over 20 genetics modification associated with AMD but there is no single gene that “causes AMD in all cases.” The genes most highly associated with AMD are found in the complement system, an important system related to controlling the inflammation in our body. A change in the complement factor H (CFH) gene from a low risk gene to a high risk gene has been associated with 43% of those developing AMD.

However, some people who have this high risk CFH gene but never develop AMD. This leads us to believe that the genetics are not the entire answer. The other factor has to do with the environment. Smoking is the leading risk factor, along with aging, exposure to sunlight and higher body mass index (obesity). But again there are obese people that smoke and never develop AMD. So, while the environmental risk factors are important, they do not answer the entire question of “why do some people get AMD but others do not?”

Recently, researchers have recognized that a major factor in the dry form of AMD is that the retinal cells begin to die off. Therefore, they have looked at important factors that keep cells alive. The mitochondria are one of the most important elements that protect the cells in the body. These subunits or organelles, produce energy for the cells, acting like batteries for the cells. And just like the batteries in a flashlight – if the batteries are not working then the flashlight dies. The same thing happens with cells – when the mitochondria are not healthy, then the cells eventually will die. Therefore to protect ourselves, it is important to keep the mitochondria healthy. One way to do this is to eat healthy foods. Over the past 20 years, the National Eye Institute (NEI) has conducted a series of studies that have identified foods and supplements that are good for the retinal cells and also the mitochondria.

super greens, spinach The National Eye Institute has recommended that people who are high-risk for developing AMD eat diets rich in green leafy vegetables, whole fruits, any type of nuts and omega 3 fatty acids. Many of these foods have anti-oxidant properties that help to “turn off” genes involved with inflammation, an important factor of retinal diseases. Salmon, mackerel and sardines have the highest levels of omega-3 fatty acids. An analysis that combined the data from 9 different studies showed that fish intake at least twice a week was associated with reduced risk of early and late AMD. Other studies show that Omega-3 fatty acids improve mitochondrial function, decreases production of reactive oxygen species (free radicals that damage cells) and leads to less fat accumulation in the body. The green leafy vegetables contain important protective macular pigments (carotenoids) called lutein and zeaxanthin that reduce the risk of AMD by 43%. High levels of lipid or fat deposits in the body (obesity) can “soak-up” the lutein and zeaxanthin so that they are not available to protect the retina.

The goal is to increase the omega-3 fatty acid and carotenoid levels to protect the eye. Below is a list of foods that are eye healthy:

Foods that have lutein or zeaxanthin:

– 6mg/d of lutein and zeaxanthin – decreased

– Lutein/zeaxanthin content – ug/100g wet weight

– Kale, cooked – 15,798

– Spinach, raw – 11,935

– Spinach, cooked – 7,053

– Lettuce, raw – 2,635

– Broccoli, cooked – 2,226

– Green peas, cooked – 1350

Source: Johnson, et al 2005 Nutr Rev 63:9

To help kickstart an eye healthy diet, here is a list of “eye-healthy recipes” that provide nutritional support for the mitochondria and retinal cells.

Asparagus Soup
Kale Chips
Quinoa Collard Green Wraps with Summer Vegetables
Smoked Salmon Rillettes

Sources:
Geoffrey K. Broadhead, John R. Grigg, Andrew A. Chang, and Peter McCluskey Nutrition Reviews. Dietary modification and supplementation for the treatment of age-related macular degeneration VR Vol. 73(7):448–462

Chong et al., Dietary omega-3 fatty acid and fish intake in the primary prevention of age-related macular degeneration: a systematic review and meta-analysis. Arch Ophthalmol 2008;126:826–33.

5/19/16

courtesy of the

Women’s Eye Health

With this being Women’s History Month, we thought it appropriate to discuss women’s eye heath. Your vision is one of the most important things in your life. Vision loss can make everyday tasks more difficult, impede your work and lead to depression.

According to Prevent Blindness America (PBA), 66% of people who are blind or visually impaired are women. This is primarily due to the fact that women have more risk factors for vision loss than men. Sadly the same study also revealed that only 9% of women realize this. Early intervention can help prevent blindness in many cases. Many blinding eye diseases can be treated to prevent blindness and almost all eye injuries can be prevented.

Here is a closer look at why women are affected more than men, and what condition they need to be aware of for early diagnosis and sight-saving treatments.

Why Women Lose Vision

They live longer than men and many eye diseases are age-related. Examples are cataracts, macular degeneration and diabetic retinopathy. The rates of these diseases are increasing as the baby boomer population ages.

Some eye diseases are intrinsically more prevalent among women, like dry eye syndrome which is believed to be linked to hormones. It is 2-3 times more likely in women than men. Hormonal changes can influence vision changes across the life span of a woman, from pregnancy to post-menopause.

Women have higher rates of autoimmune diseases such as lupus, rheumatoid arthritis and multiple sclerosis. The serious side effects of these conditions can affect your eyes, causing vision loss.

Social and economic factors can access to health care for women restricting early detection and treatment which could prevent or limit vision loss.

While behavioral and environmental factors are not restricted to women, poor nutrition and obesity can cause diabetes and subsequent diabetic retinopathy; while smoking is also a proven risk factor for eye diseases such as cataracts and macular degeneration. Women under 23 are the fastest growing segment of new smokers.

Eye Conditions More Prevalent in Women

Cataracts are the world’s leading cause of blindness. They are the result of a clouding of your eye’s normally clear lens. They can be treated with cataract surgery, where the cloudy lens is replaced with a clear synthetic lens.

Glaucoma is the second-leading cause of blindness in the Us. It is called the silent thief of sight because there is no warning. It happens when pressure in the eye — intraocular pressure or IOP — is too high, damaging the optic nerve which sends vision signals to the brain. Open-angle glaucoma, the most common type, affects men and women equally. But women are 2-4 times more likely than men to get closed-angle glaucoma. One of the possible reasons for this is that the front chamber between the iris and cornea is shallower in women than men and can block fluids from draining out of the eye, thus increasing pressure. Glaucoma is also genetic, meaning you are at higher risk if someone in your family has had glaucoma. When caught early, there are treatments that can help control your IOP. If it is not controlled early, blindness can result and it is irreversible.

Age-related macular degeneration (AMD) is the number one cause of vision loss in people over 40 in the US. One of the reasons women are at higher risk is because they tend to live 5-7 years longer than men. AMD gradually destroys the central part of your sight that helps you read or drive. There are two types of AMD. Dry AMD, which occurs when drusen accumulate under the retina. There is no treatment for dry, yet accounts for 90% of the cases. Wet AMD occurs when new blood vessels grow and leak between the retina and eye’s outer layer. There is a treatment of anti-VEGF injections for this version of AMD. The earlier the disease is diagnosed and treated, the better the results. Like glaucoma, it is an inherited eye disease.

Diabetic retinopathy is a result of diabetes. When blood sugar levels are too high, the vessels that feed the retina weaken and eventually leak, which cause the macula to swell. In its most dangerous form the retina may detach from the back of the eye leading to blindness. Diabetes is also hereditary, but controllable with early diagnosis and treatment.

Dry eye syndrome occurs when your eyes produce too few tears. Your eyes may burn, sting or feel gritty, making your vision blurry or you may blink more. Contrary to the name, you may appear weepy as the dryness may stimulates more tear production. Thanks to hormones, women are more susceptible. In postmenopausal women, the shift in balance between estrogen and progesterone can be responsible.

Pregnancy-related eye changes, like menopause, are caused by hormone shifts and can cause several temporary eye conditions, such as dry eye and corneal swelling.

3/10/16

Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

The Brain and the Eye – How They Work Together

The Brain and the Eye

The eye works like a camera. The iris and the pupil control how much light to let into the back of the eye, much like the shutter of a camera. When it is very dark, our pupils get bigger, letting in more light; when it is very bright our irises constrict, letting in very little light.

The lens of the eye, like the lens of a camera, helps us to focus. But just as a camera uses mirrors and other mechanical devices to focus, we rely on eyeglasses and contact lenses to help us to see more clearly.

The focus light rays are then directed to the back of the eye, on to the retina, which acts like the film in a camera. The cells in the retina absorb and convert the light to electrochemical impulses which are transferred along the optic nerve to the brain. The brain is instrumental in helping us see as it translates the image into something we can understand.

The eye may be small, but it is one of the most amazing parts of your body. To better understand it, it helps to understand the different parts and what they do.

Choroid
A layer with blood vessels that lines the back of the eye and is between the retina (the inner light-sensitive layer that acts like film) and the sclera (the outer white part of the eyeball).

Ciliary Body
The muscle structure behind the iris, which focuses the lens.

Cornea
The very front of the eye that is clear to help focus light into the eye. Corrective laser surgery reshapes the cornea, changing the focus to increase sharpness and/or clarity.

Fovea
The center of the macula which provides the sharp vision.

Iris
The colored part of the eye used to regulate the amount of light entering the eye. Lens focuses light rays onto the retina at the back of the eye. The lens is transparent, and can deteriorate as we age, resulting in the need for reading glasses. Intraocular lenses are used to replace lenses clouded by cataracts.

Macula
The area in the center of retina that contains special light-sensitive cells, allowing us to see fine details clearly in the center of our visual field. The deterioration of the macula can be common as we age, resulting in age related macular degeneration.

Optic Nerve
A bundle of more than a million nerve fibers carrying visual messages from the retina to the brain. Your brain actually controls what you see, since it combines images. Also the images focused on the retina are upside down, so the brain turns images right side up. This reversal of the images Is a lot like what a mirror does in a camera. Glaucoma can result when increase pressure in the eye restricts the flow of impulses to the brain, causing optic nerve damage and makes it difficult to see.

Pupil
The dark center opening in the middle of the iris changes size to adjust for the amount of light available to focus on the retina.

Retina
The nerve layer lining the back of the eye that senses light and creates electrical impulses that are sent through the optic nerve to the brain.

Sclera
The white outer coating of the eyeball.

Vitreous Humor
The clear, gelatinous substance filling the central cavity of the eye.

3/3/16

Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

4 Super Greens for Better Sight

A healthy diet not only helps your heart, but also your eyes. Your diet should include lots of fruits and vegetables to provide you with a natural source of nutrients to help protect your sight. As wonderful as supplements are, eating the actual foods is always better. Some of the best vegetables for you are the dark, leafy greens that are rich in valuable vitamins and nutrients. These are the super greens for better sight.

With the US experiencing bitter, freezing temperatures on the East Coast, while the West Coast is having summer in February, with record-breaking hot temperatures, I thought it would be interesting to see how you could enjoy those super greens, no matter what the temperature is outside. Below is a quick look at four dark leafy greens that are a great addition to a healthy diet, watercress, arugula, spinach and kale. For each vegetable I have included a recipe that is served hot, along with one that is served cold.

Here is what you need to know about super greens for better sight.

WATERCRESS

Watercress is a cruciferous plant and part of the brassica family, like arugula and kale. It contains vitamins A, B6, B12, C, K, iron, magnesium, calcium, phosphorus, lutein and zeaxanthin. In fact, weight for weight, watercress contains more vitamin C than an orange, more calcium than milk, more iron than spinach and more folate than bananas. Watercress has the highest amount of nutrients for the smallest amount of calories.

The health benefits of watercress include boosting immunity, cancer & diabetes prevention, reducing cognitive decline, thyroid support, better cardiovascular health and stronger bones. As for your eyesight, it can help prevent or slow the onset of age-related macular degeneration and possibly cataracts.

Watercress is most commonly enjoyed fresh in salads, but can also be use in pastas, casseroles, soups and sauces. Choose watercress with deep green, crisp leaves, with no signs of wilting. Trim the stems, rinse the greens in cold water and dry. It is best if used immediately, but can be store for up to four days in the refrigerator.

Watercress Soup by William Anatooskin

Watercress and Grapefruit Salad by Martha Stewart

ARUGULA

Arugula is also known as a salad or garden rocket. It is a small low growing herb that is packed with vitamins, minerals and antioxidants. It is rich in folates, vitamin A, B-complex, C and K and has copper, iron, calcium, potassium, manganese and phosphorus.

The health benefits of arugula include a lowered risk of cancer, healthy bones, strengthened brain function, improved mineral absorption and it boosts the immune system. Because of being a source of carotenoids, it also helps to slow the progression of age-related macular degeneration.

Arugula is popular in salads, used with milder greens to add a peppery flavor. But it can also be used in pastas, casseroles, pizzas, soups and sauces. Choose arugula that is crisp with green young leaves. Avoid the flowered harvest as those leaves are tough and have a bitter taste. Wash leaves in a bowl of water, swishing thoroughly to get rid of all sand and soil. Drain and pat dry before storing in the vegetable bin of your refrigerator for no more than a few days.

Grilled Stuffed Swordfish by Stormy Scarlett

Pasta Salad with Goat Cheese and Arugula by Martha Stewart

SPINACH

Spinach is a very popular leafy green vegetable, with two common varieties cultivated for food; the savory-type with dark green crinkled leaves and the flat-leaf type with smooth surfaced leaves. Spinach contains vitamin A, B-complex, C and K, along with lutein, zeaxanthin beta-carotene, potassium manganese, magnesium, copper and zinc.

The nutrients in spinach help improve blood glucose control in diabetes, lower the risk of certain cancers, reduce blood pressure, increase bone health and help iron deficiency. The lutein, zeaxanthin and beta-carotene help to potentially prevent and slow the progression of age-related macular degeneration. Lutein also works to protect the eye from free radical damage by helping filter out damaging blue and ultraviolet light.

Spinach is a universally popular vegetable, used around the world in a variety of ways, including salads, soups, noodles, pies, casseroles, dips, sauces, etc. Look for leaves that are dark green in color, crisp and not dull or yellow and spotted. Wash thoroughly to remove sand and soil, dry, trim away tough stems and store in the refrigerator for up to a week.

Turkey-Spinach Meatballs from Bon Appètit

Spinach Salad with Dates from Bon Appètit

KALE

Kale is a member of the mustard and cabbage families and has more nutrients than spinach. Less than ½ cup has 333% of the recommended daily allowance (RDA) of vitamin A, 587% RDA of vitamin K and 200% RDA of vitamin C. This frilly-leafed vegetable also has vitamin B-complex, lutein, zeaxanthin, beta-carotene, copper, calcium, sodium, potassium, iron, manganese, and phosphorus.

The health benefits of kale include healthy muscles and skin, improved blood glucose control, lower colon and prostate cancer risk, better cardiovascular health, stronger bone health, reduced neuronal brain damage and support for red blood cell formation. The advantage for your eyes comes from the lutein, zeaxanthin, beta-carotene and vitamin A, all which work to support a healthy retina. They help protect against blue and ultraviolet light as well as the early onset and progression of age-related macular degeneration. Because of the positive impact on diabetes it also reduces the onset and progression of diabetic retinopathy.

Kale is very versatile and can be served in a variety of ways including salads, soups and casseroles. It can also be braised, broiled, sautéed and even made into kale chips by tossing them in extra-virgin olive oil and sprinkled with your choice of cumin, curry powder, chili powder, red pepper flakes or garlic powder and baking at 275 degrees for 15-30 minutes depending on how crisp you want them to be. When shopping for kale look for leaves that are crispy and crunchy with a brilliant dark blue-green color. Wash thoroughly to remove soil and sand, dry well, and remove all tough stems. It is extremely perishable, so use it as quickly as possible.

Kale and Chicken Casserole by Martha Stewart

Kale with Pomegranate Dressing and Ricotta Salata from Bon Appètit

All of these dark green leafy vegetables are not only healthy for you, but can be used in many ways to make it easy to incorporate them into your diet. Here are a few ideas:

Throw a small handful into your blender when making your favorite smoothie
Add them to your next omelet or egg scramble
Use them for making pesto or adding to pasta sauce
Sauté with a small amount of extra-virgin olive and season with freshly ground black pepper and freshly grated Parmesan cheese to serve at a topping for your baked potato
Add it to your wrap, sandwich or flatbread

2/17/16

Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Layers of the Retina

The retina at the back of the eye is essential for all vision. Each layer of cells in this tissue serves a specific purpose. As we prepare for Age-Related Macular Degeneration Awareness Month in February, a closer look at the layers of the retina and their function.

Layers of the Retina

Choroid – This is made up of a layer of blood vessels that supply oxygen and nutrients to the retina. Defect in the CHM gene can cause choroideremia, leaky blood vessels can expand in the retina causing wet age-related macular degeneration (AMD) and diabetic retinopathy.

Retinal pigment epithelium – This is a single layer of cells that provide essential nutrition and waste removal for the photoreceptor cells. Accumulation of waste can lead to AMD and Stargardt disease.

Photorecptors – This is where the rods and cones are located that convert light into electrical signals. Rods help you with night and peripheral vision. Cones are more concentrated in the macula (the central part of the retina) and proved central and color vision. Death of the rods can cause vision loss called retinitis pigmentosa, while AMD is the loss of central vision.

Horizontal cells – These cells are connect to the photoreceptors that surround the bipolar connected photoreceptor cells and help the help integrate and regulate the input from multiple photoreceptor cells, increasing your visual acuity.

Bipolar cells – The dependence of each layer of the retina on each other is exemplified here. These cells take the electrical information from the photoreceptor cells and pass it along to other retinal cells.

Ganglion cells – These cells extend to form an optic nerve that conveys information to the brain and take the electrical information from the bipolar cells and process it to determine shapes, contrast and color. Glaucoma vision loss results from high intraocular pressure that affects the optic nerve, interrupting the signals to the brain.

5 Elements of Accessible Web Design

A common misconception is that all you need to have a successful blog or website is good content. While content people want to read is important, if you can’t see it, or it is difficult to read, very few people are going to take the time to try. There is lots of good content to choose from.

Making your content easy to scan and read and using great graphics that can tell a story are just as important. Especially if you want to reach the millions of potential readers that are blind or visually impaired.

While a person with low vision (due to age-related macular degeneration, cataracts,glaucoma or other eye diseases that are related to aging) can increase font size or graphics by enlarging them with a pinch of the fingers or scroll of the mouse, the result is often blurry and still difficult to see.

If a person is blind and using a screen reader, what they hear may not match what is written or displayed. A picture without underlying descriptive text is worthless. And when a blind person is using a screen reader to read a web site, they will often tab from link to link to scan your article, skipping over your text, to get a sense of what the options are. “Click here” says doesn’t tell the reader anything.

Here are 5 essential elements of accessible web design.

12/15/15

Susan DeRenmer, CFRE
Vice President of Development
Discovery Eye Foundation

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Similar Diseases, Different Locations, Possible Common Treatments

Similar Risk Factors

Future Treatments

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.

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:

Foods that have lutein or zeaxanthin:

The Brain and the Eye

Layers of the Retina

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