Cancer in the EYE: Unexpected Thought

When you think of cancer, most of us do not think about the eye or vision. Though rare, cancer can start inside or outside of the eye. If cancer starts inside the eyeball it’s called intraocular and if it starts outside the eye (eyelid or in the eye socket) then it’s called extraocular tumor. It can occur in both children and adults. Most major eye centers have specialists who are trained in the diagnosis and treatment of eye cancers.

Here are a few types of cancer in eye:

  • Eye Cancer in Children: The most common cancer seen in the eye of children is retinoblastoma. This occurs in children at very early age so these are the youngest cancer patients. This cancer starts inside the eye and affects the retinal cells. This is a cancer that presents very quietly, the child has no pain, no complaints and plays happily without any problem until one day parents notice that the pupil of the eye has some abnormal ‘White Glow’ (leukocoria) rather than the usual ‘red-eye’ reflection seen in a photo—that can be the first sign of retinoblastoma. So, it requires prompt evaluation by an ophthalmologist. Retinoblastoma is a curable cancer but if it is not treated on time, it can grow quickly and fill the eyeball. It can lead to loss of vision and life-threatening problems.

At the later stage of this cancer, the only one way to survive is to remove the eyeball (enucleation). Like many of other types of cancer, retinoblastoma has a genetic component so genetic testing needs to be done. The tumor begins with the RB1 gene mutation that stimulates retinal cells to develop into a tumor called a retinoblastoma. The RB1 mutation can be inherited from the parents, but in some cases it is sporadic and not inherited. There are various treatments such as surgery, chemotherapy, radiotherapy etc. to cure retinoblastoma cancer. Rarely it can spread beyond the eye. 

  • Eye Cancer in Adults: The development of a tumor in the back of the eye in adults can be from a metastatic cancer from elsewhere in the body or can arise in the eye itself. The most common primary eye cancer is called uveal melanoma and is a cluster of rapidly growing cells underneath the retina, which can lead to vision loss. The tumor can also appear as a dark black spot on the iris. Ideally the uveal melanoma can be treated when the tumor is still only in the eye.However, unfortunately, in approximately 50% of patients the uveal melanoma spreads (metastasis) to other part of the body, making it the most dangerous eye cancer in adults. Depending upon its location the uveal melanoma may not cause early symptoms but the patient may experience blurred vision or large numbers of floaters. The uveal melanoma can be diagnosed only when an ophthalmologist or eye care specialist examines your eye. What is the main cause of uveal melanoma? How it starts, grow and spread? These questions are still unanswered. The risk of this cancer increases in persons having fair skin (white), light eye color and inability to tan. There are certain changes in the genes linked to uveal melanoma. Currently the most common are GNAQ and BAP-1 gene mutations that are associated with greater risk of metastasis, where it spreads to other parts of the body. The standard treatment of this tumor is fine-needle aspiration biopsy (FNAB), brachytherapy (radioactive material inside a small capsule placed next to the tumor), radiation therapy and possibly enucleation. 
  • Metastasis to Eye: Finally, the other types of cancers found in the eyes are because of the spreading of a primary cancer (from a distant site such as the breast, lung or liver) to the eye.  Sometimes an eye exam can identify a metastatic tumor before the primary tumor is recognized elsewhere in the body.  Examples of cancers that spread to the eye are breast cancer in women and lung cancer in men. Less commonly, the prostate, kidney, gastrointestinal and blood cancers (leukemia and lymphomas) can spread to the eye.  Treatment depends on the type of cancer involved. 
  • Eye Damage from Chemotherapy: Eye problems can also develop through the side effects of chemotherapy or hormone therapies given for tumors outside the eye. When a person has any type of cancer, they often must undergo treatments with chemotherapeutic drugs.  A commonly used cancer drug is called cisplatin.  When treated with cisplatin, there can be damage to the retinal pigment epithelial cells in the inner part of the retina. Hemorrhages or bleeding can occur within the retina itself and vision can decrease temporarily. If a person is undergoing cancer treatments, it is a good idea to have their eyes checked, especially if they are having any vision problems. The chemotherapy does not actually cause cancers but only side effects.

Therefore, if you are having any decreased vision, it is always makes sense to have a good eye examination to identify any problems at early stage.

June is Cataract Awareness Month

I remember my father experiencing the removal of cataracts in the early 60’s, and being told by his Ophthalmologist that the recovery time would be weeks rather than days and a positive outcome was not guaranteed.  The truth is that surgery of any kind carries with it a certain amount of risk.  But now the removal of cataracts has become routine for thousands thanks to amazing technology and gifted eye surgeons.  To the doctor, the surgery might be considered routine.  But to the patient, when vision is at risk their concerns and real fears are not in any way routine.

A year ago at 96 years young, my friend and actress Betty White was worried about her vision.  She told me that she was having a great deal of difficulty reading scripts and that her eyes would tire with the strain of trying to see the pages.  Her ophthalmologist determined that the removal of cataracts was necessary and the surgery on the first eye was scheduled for the next Tuesday.  “Is it safe? she asked me.”  I assured my friend that the removal of cataracts was not something to be afraid of.  “It’s routine” I told her.  “Please don’t be frightened.” Betty’s surgery was completely successful.  In fact, she tells me she can read everything including the smallest print on any label.

At the Discovery Eye Foundation (DEF), we are committed to supporting research that we believe will make the treatment of many forms of vision loss far more predictable and successful. Whether it’s through the breakthroughs in surgery or the development of new drugs or the advancement in genetics or the use of stem-cells the major forms of vision loss are being greatly affected through the power of your contributions and the commitment of the gifted researchers DEF supports. 

Please know that the dollars you contribute to DEF will go directly into the hands of the researchers where they can do the most good.

All of us at the Discovery Eye Foundation thank you for your support and look forward to a time when most forms of blindness will no longer limit vision.

 

Tom Sullivan
DEF’s Ambassador of Vision
sullivanvision.com

Low Vision

Low vision is the term used to describe significant visual impairment that can’t be corrected fully with glasses, contact lenses, medication or eye surgery.  Low vision causes a person to be unable to accomplish some daily tasks due to sight impairments. Low vision occurs when an individual struggles with any of the following common activities:

  • Reading
  • Everyday tasks like personal grooming
  • Viewing photos
  • Recognizing faces

Millions of Americans experience a normal loss of vision as they get older and the number of individuals who develop vision problems due to health conditions is projected to continue to rise.

There are many things that can cause low vision, including:

A few simple approaches can be:

  • Getting an eye exam
  • Update your reading glasses
  • Use bright light for reading

If these do not work for you, ask your eye care professional for help or ask for a referral to a low vision specialist.

Low Vision Technology 

Individuals with eye disease related to age, or vision compromised due to injury, may benefit from the usage of low vision devices.

There are two primary categories for low vision devices: Magnifiers for viewing things and objects that are close to you (magnifying lenses or machines), and magnifiers used for viewing objects and images at a distance (telescopic lenses). Many lighted magnifiers for close objects improve readability by increasing illumination.  With the advances in technology, many low vision devices are available to provide multiple function (near and distance) magnification and visual aid.

Technology is advancing to meet the growing needs of people with low vision impairment. There are a number of products that can help individuals with low vision. While considering the correct vision enhancer, keep in mind a few objectives:

  • What is the visual ability of the individual? Low vision aids are created with different options for specific low vision needs.
  • What tasks will the visual enhancer be used for? Find out what each product is best used for to decide if it will meet the needs of the individual.
  • Is the device easy to use? The right device should be easy for you to use.
  • How much does it cost? The cost of low vision aids can vary depending on a number of factors.

Popular products include:

Portable magnifiers and lighted magnifiers- offer magnified reading on the go. Perfect for menus, shopping lists, label reading, and more, portable magnifiers can fit in your pocket, purse, or be worn on the belt for quick, easy use.

 

Wearable magnifiers – wearable technology is the future for those with low vision who live an active lifestyle.  Wearable options make it possible to see and take part in everyday tasks, such as reading and recognizing faces.

 

Transportable magnification screens– are perfect for close up viewing as well as distance viewing. These great viewers offer great flexibility, from watching TV to using the mirror image feature for self-viewing. There are APPS for smart phones that can be used to magnify reading material.

  

Desktop devices for reading books, bills or letters – these have large, bright screens. A reading table offers visual aid for reading books, optional computer connectivity and more. This family of portable magnification units offers up to 75x magnification.

 

 

Consult a Low Vision Specialist–Consider making an appointment with a trained low vision specialist if you have specialized needs. They are available in larger cities or can be found by contacting The Braille Institute or by an internet search. Talk with your low vision specialist to find out which is right for you and where you can find them.

In addition to low vision devices and good lighting, inexpensive non-optical adaptive aids can assist with routine daily activities. These devices include:

  • Large-print cookbooks
  • Large-numbered playing cards, clocks, telephones and watches
  • Electronic “talking” clocks, kitchen timers, thermometers, blood pressure meters and even pill bottles
  • Large felt-tip pens and wide-lined paper for writing notes
  • Color-coded pill boxes
  • Signature guides help in writing your signature in the correct place

Many of these items can be found at your local drugstore, discount store or bookstore. Your low vision specialist can recommend retail sources for non-optical adaptive aids.

Vision loss can definitely be alarming but learning how to adapt, with the aid of low-vision specialists, can result in continued independence.  As low vision aids are tools focused on helping with the physical aspect, it is also important to seek the help of a counselor for psychological counseling if needed or join a support group, that may provide the help you need. Finally, maintaining a social network and asking for help will enrich your life, and help maintain your independence and quality of life.

Resources:
www.enhancedvision.com
www.allaboutvision.com
www.nei.nih.gov
www.brailleinstitute.org
www.visionaware.org
www.aao.org
www.amd.org
www.californiaphones.org
 

 

 

 

 

 

IN MY MOTHER’S EYE

There is an old Irish ditty I often heard as a little boy.  It goes something like this:

“One bright and guiding light that taught me wrong from right I found in my mother’s eyes. Those baby tales she told of roads all paved with gold I found in my mother’s eyes”.

As a blind child there was so much I found in my mother’s eyes.  From as early as I can remember, she read me stories that spanned from Robert Lewis Stephenson’s adventures like “Treasure Island” to the book that always made both of us cry – “Black Beauty.”

As a teenager and young adult, her eyes made it possible for me to venture into the world knowing as she liked to say…”dressed to the nines.” And then, when I married my wife, Patty, my mother had strong opinions about the choice of tuxedo I should wear on our wedding day.  I can still remember hearing her talk about how much she loved to see the first smiles on the faces of our children, Blythe & Tom. 

As she grew older, it was her eyes that kept her connected to the world.  Every morning, she read her Boston Globe from cover to cover, and on afternoon television she never missed her Soap Operas – “The Guiding Light,” and “Search for Tomorrow.” And then, there was the NBC Nightly News with her on-going crush on Tom Brokaw.

April is Women’s Eye Health Month along with celebrating the need for Sports Eye Safety.  I can still remember my mother crying when she watched Cleveland Indian’s left-handed pitcher Herb Score hit with a line-drive costing him his sight.  Research goes hand in hand with eye-safety to preserve vision.  The Discovery Eye Foundation is committed to finding the answers that will preserve vision and allow women and mothers the blessing of seeing the smiles on the faces of the children they love.

 

Tom Sullivan
DEF’s Ambassador of Vision
sullivanvision.com

Too Much Screen Time:  Is it bad for kids?

Children and their phones, iPads and gaming devices are inseparable today. Most are growing up with a wide selection of electronic devices at their fingertips. They can’t imagine a world without the internet, smartphones and tablets.  Although, all that reading and playing games on their handheld devices may be harmful.  But it’s not just kids who are getting too much screen time. Many parents struggle with over use of screen time themselves.  So it’s important to understand how too much screen time could be harming everyone in the family.

Children can experience at least one of the following symptoms after being exposed to more than two hours of screen time per day:

  • Headaches
  • Neck/shoulder pain
  • Eye strain, dry or irritated eyes
  • Reduced attention span
  • Poor behavior
  • Irritability

Any of these symptoms could potentially affect academic performance and social interactions.

The worldwide rapid rise of nearsightedness has been linked to increased use of and exposure to electronic devices. However, spending more time outdoors, especially in early childhood, can decrease the progression of nearsightedness.

Blue Light can be harmful

The LED screens of computers and portable digital devices emit a broad spectrum of visible light. Most of these light rays are harmless, but a portion of the light emitted by these screens is relatively high-energy visible light called “blue light.”

Blue light has shorter wavelengths and higher energy than other visible light rays. Some laboratory research suggests certain bands of blue light may be harmful to the light-sensitive retina of the eye over time.

Blue light also plays an important role in regulating our body’s circadian rhythm. This basically is an internal clock that’s running in our brain and cycles between alertness and sleepiness at regular intervals over a 24-hour period.

Too much exposure to blue light at the wrong time of day can disrupt a person’s normal sleep/wake cycle, which can have serious health consequences.  Sleep disruption can be especially problematic for children, leading to daytime drowsiness and poor performance in school. Some authorities feel that disruption of the sleep/wake cycle also can eventually lead to weight gain and obesity-related health problems.

Research has shown that people who experience disrupted 24-hour cycles of sleep and activity also are more likely to have mood disorders, lower levels of happiness and greater feelings of loneliness.

How to cut back on screen time

  • Set a limit on daily screen time. Make it clear to your kids and stick to it.
  • Encourage your child to spend some of that screen-free time outdoors while it is still light.
  • Establish screen-free zones: For example, no smartphone use for anyone in the family in the car,  at restaurants, or at the dinner table.
  • No screens in the bedroom when it is time for bed. No exceptions.
  • As parents you can be a model for moderate screen use. Show your children, with your own behavior, how to live a rich, varied and healthy life where all habits are practiced in moderation.

It is also very important to teach your child good eye habits, below are few tips from experts:

  • You can set a kitchen timer or a smart device timer to remind them.
  • Alternate reading an e-book with a real book and encourage kids to look up and out the window every two chapters.
  • After completing a level in a video game, look out the window for 20 seconds.
  • Pre-mark books with a paperclip every few chapters to remind your child to look up. On an e-book, use the “bookmark” function for the same effect.
  • Avoid using a computer outside or in brightly lit areas, as the glare on the screen can create eye strain.
  • Adjust the brightness and contrast of your computer screen so that it feels comfortable to you.
  • Use good posture when using a computer and when reading.
  • Encourage your child to hold digital media farther away, 18 to 24 inches is ideal.
  • Create a distraction that causes your child to look up every now and then.
  • Remind them to blink when watching a screen.

Finally, it is very important to make sure your child gets a regular eye exam by a pediatric ophthalmologist or optometrist.  This will help monitor your child’s vision and eye health.

Age-Related Macular Degeneration Month

Have you ever noticed how many people, places, things, and even a rather unattractive groundhog are designated and honored with a day, a month, or a year?  Now, I am not putting down Punxsutawney Phil because I do want him to see his shadow and promise us an early spring.  In our designation of things, we also should pay homage to values and causes that are important in our history and our health.  I am glad that I am reminded every November of our Veterans on a special day or the Presidents who have served our nation.  Certainly Dr. King’s birthday and Black History Month place an appropriate focus on issues that society is still working to solve.

So, I was delighted when I heard that February is Age-Related Macular Degeneration Month.  More than any other eye disease AMD affects the largest number of people over 65 of European lineage.  In fact, as I write this piece, over 15 million Americans are struggling within its dry form, currently an incurable condition.  It’s projected that if we are not able to solve the riddle of AMD by the year 2050, the number of senior Americans with AMD will be more than 30 million.

The Discovery Eye Foundation is committed to finding the answer that will preserve the vision of millions of people.  Right now research supported by DEF at the Gavin Herbert Eye Institute, University of California Irvine, Medical School is on the cutting edge of promising breakthroughs that could make the difference in the lives of so many.  

Please join me in supporting this most worthy effort by contributing whatever you can to DEF and its important work.  Our vision may depend on your generosity.

 

Tom Sullivan
DEF’s Ambassador of Vision
sullivanvision.com

Mitochondrial Revolution: New Hope for AMD and Aging Diseases

How many times have we heard: “This field has been thoroughly studied, and we know all there is to know; there is no reason to continue investigating, because there is nothing more to find out on the subject”? This has been the attitude of some researchers with respect to the importance of mitochondria and diseases. For more than 50 years, we have known that mitochondria, which are the “batteries” of the cell, are critical for energy production. But many believed they did not have other major roles in the health of the cell, so when it came to developing drugs against diseases, mitochondria were overlooked.

That idea has now been turned on its head.

Mitochondria

Led by Discovery Eye Foundation (DEF) Research Director Dr. Cristina Kenney, the Mitochondria Research Group believed that, to really discover something new, you have to look in novel areas. This group has done just that. Using the transmitochondrial cybrid model, which are cell lines with identical nuclei, but with each line containing mitochondria from a different person, they have shown that the mitochondria have major regulation powers over cell behavior and expression of disease-related pathways. This is significant, because the mitochondria then become a target for therapies to combat diseases.

Kenney’s group is investigating various drugs and substances that will keep the mitochondria healthy and, ultimately, improve the health of the retinal cells in age-related macular degeneration (AMD). But it does not stop there. This same approach to developing mitochondria-targeting drugs is being pursued for drugs to treat Parkinson’s disease, Alzheimer’s disease, leukemia, various cancers, heart failure, thrombosis, stroke, diabetic retinopathy, Leber hereditary optic neuropathy, and even liver toxicity from acetaminophen.

The continued support from DEF, especially in the early stages of the mitochondria research, has fostered a new area to be opened up, specifically for AMD and diabetic retinopathy. In turn, this has allowed new collaborations among Kenney and researchers from the eye field, and laboratories studying the brain and neurodegeneration, cardiology, cancer therapies and methods to reduce side effects from cancer drugs. Kenney’s discoveries using cybrids have revolutionized the field of mitochondrial research, showing that mitochondria have wide-ranging biological effects never imagined and opening up the field of mitochondrial therapy to careful investigation.

You can help make a difference by supporting DEF’s sight saving research. Help our researchers advance AMD research by donating today! 

DonateNow

 

Lauren HauptmanLauren Hauptman
Lauren Hauptman Ink

My Best Gift!

The other day my daughter Blythe asked me which Christmas I consider to be my favorite.  I had to think a minute, because as a family, the Sullivan’s have had some great ones.  I was about to say the first time you and your brother Tom were old enough to really get into Santa, being absolutely sure that the fat man brought your presents right down the chimney.  I was about to say that, and then I remembered. 

The greatest Christmas I ever enjoyed was a ski trip in Winter Park, Colorado, when our children were teenagers and our friend, the marvelous Betty White, joined us for a Christmas Eve sleigh ride none of us will ever forget.  The night was perfect.  It had snowed earlier that day, and the air had a feeling of Christmas that you could almost taste.  Oh, sure, it was cold, but we were bundled up under tons of blankets as two beautiful Clydesdale horses with bells jingling took us through the woods to a magical barn where dinner would be served and carols sung. 

It was on the way home that my Christmas was made complete.  We had stopped to let the horses breathe, and everyone was quiet, just allowing the feeling of togetherness envelope us in that special night.  It was Betty who broke the silence. 

“Tom,” she said almost to herself, “I wish I may, I wish I might, let you see the stars tonight.  I feel like we could almost reach up and touch them.  That’s how bright and close they are.  I guess when you’re this high in the Rocky Mountains, it just feels like they’re right here.”

I could hear how much my friend wanted me to see such a heavenly display, but we both knew that could never happen.  I have no complaint about being blind, no one could have a better life, but I would be lying if I didn’t admit at this holiday season that I’d love to be able to take it all in, all the special sights of Christmas. 

Every day in laboratories around this country, researchers are working to solve the multiple eye diseases that make it impossible for millions of people to see the joys of Christmas.  At this holiday season, my best gift would be that all of us donate to the Discovery Eye Foundation with its goal to preserve vision and eradicate blindness around the world.  During this season of giving, may your hearts be light and your sight be bright. 

Merry Christmas!

Tom Sullivan
DEF’s Ambassador of Vision
sullivanvision.com

 

Keep Your Eyes Comfortable During the Cold Winter Months

Harsh weather conditions can reduce the natural moisture in your eyes and the irritation usually results in a burning or itching sensation that often leads to rubbing or scratching your eyes which can worsen the symptoms. Sometimes it feels like there is a foreign object in your eye and for some, dry eyes can even cause excessive tearing, as your eyes try to overcompensate for their lack of protective tears. Prolonged, untreated dry eyes can lead to blurred vision as well. Between the harsh winter winds outside and the dry heat radiating inside, our eyes are very quickly irritated and dried in the winter months.  The result is itchy, dry eyes that may cause pain, blurred vision, a burning sensation, or even watery vision as our eyes try to compensate for the dryness.

What Are The Symptoms?

  • Uncomfortable, stingy, burning or scratchy feeling.
  • Stringy mucus in or around your eyes
  • Increased eye irritation from smoke or wind
  • Eye fatigue
  • Sensitivity to light
  • Eye redness
  • A sensation of having something in your eyes
  • Difficulty wearing contact lenses
  • Periods of excessive tearing
  • Blurred vision, often worsening at the end of the day or after focusing for a prolonged period

10 TIPS TO KEEP YOUR EYES COMFORTABLE DURING THE WINTER MONTHS

Whatever the symptoms, dry eyes can cause significant discomfort during the long winters and relief can seriously improve your quality of life.

  1. To keep eyes moist, apply artificial tears/eye drops a few times a day. If you have chronic dry eyes, speak to your eye doctor about the best product for your condition.
  2. Drink a lot of fluids – keeping your body hydrated will also help maintain the moisture in your eyes.
  3. If you spend a lot of time indoors in heated environments, use a humidifier to add some moisture back into the air.
  4. Try to situate yourself away from sources of heat, especially if they are blowing. While a nice cozy fire can add to the perfect winter evening, make sure to keep your distance so dry eyes don’t ruin it. 
  5. Staring at a computer or digital device for extended amounts of time can further dry out your eyes. If you spend a lot of time staring at the screen, make sure you blink often and practice the 20/20/20 rule – every 20 minutes, look 20 feet away for 20 seconds. Use artificial tears often to lubricate eyes during long periods of using your eyes.
  6. Avoid air blowing in your eyes. Don’t direct hair dryers, car heaters, air conditioners or fans toward your eyes. In your car, direct heat to floor vents and away from your eyes once your windshield is defrosted.
  7. Stop smoking and avoid smoky environments.
  8. Don’t rub your eyes! This will only increase irritation and can also lead to infections if your hands are not clean.
  9. Give your eyes a break and break out your glasses. If your contact lenses are causing further irritation, take a break and wear your glasses for a few hours or days. Also talk to your optometrist about switching to contacts that are better for dry eyes.
  10. Protect your eyes. If you know you are going to be venturing into harsh weather conditions, such as extreme cold or wind, make sure you wear protection. Try large, 100% UV protective eyeglasses and a hat with a visor to keep the wind and particles from getting near your eyes. If you are a winter sports enthusiast, make sure you wear well-fitted ski goggles.

If you find that after following these tips you continue to suffer, contact your eye doctor.

I Can Only Imagine

I can only imagine my wife’s beautiful face.  Oh sure, I’ve touched it and kissed it many times.  I’ve felt the lines with the tips of my fingers, tracing our lives together, and I’ve heard her smile.  I understand that’s not really seeing it.  It’s not seeing her eyes as they sparkle with something funny I said; or, when she looks at me with love reserved only for those who are truly in love.

She’s often tried to explain the flash and colors of a sunset and the cotton softness of clouds as they drift across the sky.  And, what about a rainbow made up of all the colors that somehow promise all of us that things in the world will get better. 

How amazing it would be to see my daughter Blythe skiing her favorite Colorado Mountain trail or my son Tom riding a California wave, both so secure and happy enjoying the sports they love. 

There is so much more I wish I could see, but it’s not going to happen because I am blind.  I am left with only imagining what it’s like to have the gift of sight.

I can only empathize with how a person feels when their vision is threatened by glaucoma or diabetic retinopathy, retinitis pigmentosa, and the most devastating of all, macular degeneration.

At the Discovery Eye Foundation (DEF) our researchers are working every day to overcome the loss of vision and preserve your ability to treasure all the beauty that surrounds you.  I’ve heard it said that the eyes are the windows to the soul.  I don’t know if that’s true, but I am sure that they are the single most important sense in the group of five, and that saving vision is a cause that must be supported.

DEF is committed to that mission, and with your help, answers to all forms of eye disease will be discovered.  It’s up to all of us to support the research that’s bringing us ever closer to those solutions.

If you want to help, please click the button below or download donation form to donate by mail, click here: DEF donation form

DonateNow 

 

 

Tom Sullivan
DEF’s Ambassador of Vision
sullivanvision.com