National Glaucoma Awareness Month

January is National Glaucoma Awareness Month – An important time to raise awareness for this sight-robbing disease.

Glaucoma is an age-related disease and is the second leading cause of irreversible blindness in people over 40. Glaucoma is 6 to 8 times more common in African Americans than Caucasians. If you have a close blood relative with glaucoma, it raises your risk of getting it.

Glaucoma is the sneak thief of sight, since there are no symptoms and once vision is lost, it’s permanent. As much as 40% of vision can be lost without a person noticing.

More than 3 million people in the United States and over 60 million people worldwide, have glaucoma. Experts estimate that half of them don’t know they have it. Combined with our aging population, we can see an epidemic of blindness looming if we don’t raise awareness about the importance of regular eye examinations to preserve vision.

How to Help Raise Awareness

In the United States, approximately 120,000 are blind from glaucoma. Here are three ways you can help raise awareness:

talk to your family about glaucoma awareness — *Talk to your friends and family*

Talk to friends and family about glaucoma. Do not keep it a secret. Let your family members know.

Get involved in your community, educational seminars, support groups, and more.

Visit our website for more information on glaucoma at discoveryeye.org/eye-conditions/glaucoma/.

What is Glaucoma?

Glaucoma is a disease that causes damage to the major nerve of the eye called the op development of glaucoma tic nerve, a part of the central nervous system that carries visual information from the eye to the brain.

The eye experiences a gradual increase of intraocular pressure (IOP) due to an imbalance of the fluid produced in the eye and the amount of fluid drained. Over time, elevated IOP can cause vision loss. The most common form of glaucoma is primary open angle glaucoma which affects about 3 million Americans. However, there are other types including narrow angle, congenital, normal tension, and secondary glaucoma.

There is no cure for glaucoma—yet. However, medication or surgery can slow or prevent further vision loss. The appropriate treatment depends upon the type of glaucoma among other factors. Early detection is vital to stopping the progress of the disease.

Risk Factors

How do you know if you are at risk for glaucoma? Those at higher risk include people of African, Asian, and Hispanic descent. Other high-risk groups include: people over 60, family members of those already diagnosed, diabetics, and people who are severely nearsighted.

Regular eye exams are especially important for those at higher risk for glaucoma, and may help to prevent unnecessary vision loss. In the most common form, there are virtually no symptoms. Vision loss begins with peripheral or side vision, so if you have glaucoma, you may not notice anything until significant vision is lost.

Getting your eyes checked by an ophthalmologist regularly will be the best way to detect glaucoma or any other eye disease early.

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

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.

7 Tips for Living With Glaucoma

Did you know January is Glaucoma Awareness Month? Although no cure exists, the eye disease may be treated with medication and surgery. If left undiagnosed and untreated, however, glaucoma can cause permanent damage to vision. According to the National Eye Institute, glaucoma affects more than three million people in the United States. The population that is at highest risk is adults over the age of 60. Glaucoma affects vision by damaging the optic nerve and typical vision loss occurs in the peripheral visual field. This type of loss can create difficulty performing everyday tasks. To mark the importance of Glaucoma Awareness Month, Low Vision Focus @ Hadley offers these tips to improve independence and safety for people with glaucoma-related vision impairments.

Tips for Living With Glaucoma

Loss of peripheral vision makes it difficult to see steps and stairways. Marking treads and handrails with contrasting colored paint or tape can improve navigation and reduce the risk of falling.

Persons with glaucoma often experience difficulty adjusting to darkness or darkened rooms. Increase illumination in dark closets or hallways by installing additional lighting fixtures. When outdoors at night, carry a strong flashlight.

Area rugs can pose a hazard for persons with visual field loss. It’s best to keep home pathways and work areas free of extra floor coverings.

In all locations where you might be a frequent visitor, ask someone to give you a tour. It goes without saying you need to know where the bathroom is located, as well as how to exit the building from a variety of locations.

Some persons with glaucoma prefer to use a human guide when traveling in unfamiliar places. To use a human guide effectively, grasp the guide’s arm firmly just above the elbow and walk a half a step behind. This positioning gives the most protection from potential obstacles and allows both people to function as a team.

Get in the habit of consistently closing kitchen and bathroom cabinets, especially those above countertops. Make sure doors are either all the way open or shut. Practicing both of these safety techniques can greatly reduce the risk of head injury.

Before reaching down to pick up dropped objects, place your hand, palm out, about 12 inches in front your face. This way, you’ll make sure you don’t hit the edges of tables or countertops with your forehead.

Remember, although glaucoma cannot be cured, it can be treated. Regular eye exams, especially for adults over 60, are critical to control the spread of the disease. For those who are affected by vision loss, it’s important to remember that the acquisition of some simple adaptive skills and techniques can help maintain safety and independence. Low Vision Focus@Hadley is dedicated to assisting persons with low vision to live life to the fullest all year long. For more information on how Low Vision Focus@Hadley can help you or someone you know, please visit our website www.lowvisionfocus.org, or call (855) 830-5355 to find out about our free programs and materials.

1/12/16

Ed Haines
The Hadley School for the Blind
Low Vision Focus @ Hadley

Silent Thief of Sight – Glaucoma

January is National Glaucoma Awareness Month. The National Eye Institute, through their education program NEHEP, have created this infographic to provide you with information you need to know about this blinding eye disease.

When adults reach their 40s, they often begin to notice small changes in their vision that can affect their daily lives and jobs. It could be difficulty in reading a book or working on a computer. This can be annoying, but it can often be addressed by seeing an eye care professional for comprehensive dilated eye exam. This allows the doctor to detect diseases and conditions that can cause vision loss and blindness and yet have no symptoms in their early stages.

Silent Thief of Sight – Glaucoma

Glaucoma is one of these age-related eye diseases that has no early symptoms, which is why it is called the silent thief of sight. It is actually a group of diseases that can damage the eye’s optic nerve and result in vision loss and blindness. Open-angle glaucoma is the most common form disease.

In addition to an eye exam, you can reduce your chances of losing your vision to glaucoma by also:

Live a healthy lifestyle that includes maintaining a proper weight, eating healthy foods, and not smoking.
Know your family history to determine if you are at a higher risk for some eye diseases.
Protect your eyes against harmful UV rays from the sun or your computer by wearing sunglasses when you are outdoors or computer glasses when using the computer for extended periods of time.

Silent thief of sight glacoma — Courtesy of NEI/NEHEP

1/5/16

Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

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

Low Vision Aging Adults at Higher Risk for Falls

Low vision in aging adults varies as do the occupational therapy techniques that might help older adults in becoming more independent. Mr. P has glaucoma resulting in a narrowed field of view. He is light sensitive, and keeps his blinds closed, darkening the house. He is responsible for doing his laundry, yet his washer and dryer are in the basement, causing a safety concern. Mrs. K has macular degeneration with 20/400 visual acuity. She has severely reduced contrast sensitivity, and can no longer drive or recognize faces easily. She no longer gets to the senior center for regular exercise sessions, which is concerning to her and her OT. Ms. T was diagnosed with diabetic retinopathy. She has struggled for years to accurately see her glucometer and insulin. She has recently developed peripheral neuropathy, leading to wheelchair dependency. Each of these patients is likely to leave their home less often because of their low vision, eventually leading to a decline in lower extremity weakness, balance, endurance and confidence. The fear of falling leads to more isolation, which can cause even more lower extremity weakness, problems with balance, decreased endurance, and even depression. The irony is that this cycle, which began with caution and a fear of falling, lends itself to exactly that. . .a fall.

Why are low-vision aging adults at higher risk for falls?

According to the CDC, “Each year, millions of older people-those 65 and older-fall. In fact, one out of three older people fall each year, but less than half tell their doctor. Falling once doubles your chances of falling again.” The typical aging adult with low vision faces challenges that others do not. Difficulty seeing details combined with reduced contrast sensitivity leads to a decline in mobility and socialization.

So how do we help older adults with low vision lower their risk for falling? When considering safety within the home, persons with low vision must make it a priority to add lighting & contrast whenever possible. Consider all rooms of the house, including entrances, hallways and stairways.

Placement of night lights in hallways, stairway, etc.

Keep flashlights in accessible places throughout the home where night lights are not possible.

Instead of closing blinds, keep them open & wear appropriate colored filters to manage glare/light sensitivity.

Small battery operated stick-on lights or rope lighting is inexpensive, and easy to place on steps to light up a stairwell.

Line edge of steps, or stairway railing with brightly colored duct tape to increase visibility.

Make sure grab bars, tub benches, shower chair are high contrast, to be most visible.

Remove throw rugs, with the exception of those providing function, such as the one at the entrance and bathtub. Their purpose is for providing dry shoes and feet, but they should have a non-skid back and a high contrast color to “stand out.”

Reduce clutter in rooms to increase safety by removing items from floors, walkways and stairwells.

Consider investing in a Medical Alert System to provide added piece of mind, confidence, especially when living alone.

Persons with low vision can decrease their frequency of falls by staying social and walking in the community. Unfortunately, many low vision adults become more house bound when they can no longer drive. Locating sources of alternative transportation may be helpful. Seeing faces is difficult, making socializing a challenge, which can lead to depression. The following recommendations take into consideration the challenges of not seeing details or across the visual field normally, while improving lower body strength, endurance, coordination, confidence, and hopefully reducing the risk of a fall.

Encourage regular trips to the grocery stores and the mall to keep physically fit. Malls are safe environments to walk around because of wide, straight hallways. Use magnifiers to see price tag/label details, or take advantage of personal shoppers who assist with locating items.

Participate in regularly scheduled exercise sessions (videos, groups, etc). Sit/stand in the front row, ask instructor to provide clear verbal instruction, instead of only demonstration. Consider hiring a personal trainer in order to get 1:1 instructions for how to use exercise equipment. If watching a video, move closer to your largest TV screen. Home exercise equipment can be labeled with high contrast markings to increase visibility of its details.

Consider joining a senior center in the community. Some have low vision support groups.

Access driving alternatives, such as the Smart Bus, Senior Centers, Local Volunteer or Church groups. Consider using money previously spent for a car and its expenses to hire a private driver.

Use appropriate colored filters in bright outside conditions or darker inside environments (i.e. Amber outside in the sun; Yellow inside a dark restaurant or outside with overcast weather).

Consider using a walker or support cane when walking longer distances in the community or neighborhood. Many individuals decline using an assistive device, not realizing how active and fit it can make them. Rolling walkers are even available with seats, allowing for rest breaks wherever necessary.

While the fear of falling is great amongst all seniors, those with low vision need to consider adding strategies that specifically benefit them. Making changes within the home may be as simple as improving lighting and contrast. Remaining physically fit outside of the home may be done with shopping or exercise equipment, but either way staying active will improve confidence, the fear of falling, and hopefully decrease the chance of a fall. If you are unsure of what approach is best for you, consult with your ophthalmologist about scheduling a low vision eye exam and occupational therapy.

Reference:
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control-CDC 24/7: Saving Lives, Protecting People

12/3/15

Annette M. Babinski, OTR/L CLVT
Henry Ford Health System
Vision Rehabilitation Center

Michelle Buck, MS, OTR/L CLVT
Henry Ford Health System
Vision Rehabilitation Center

#GivingTuesday – Giving For Eye Research

Medical research funding from the US government, the medical device and pharmaceutical industries, biotech and foundations has dropped 0.8% per year, every year from 2007 to 2012. Even with the economic recovery, the funding of eye research from the NIH in 2014 decreased by 17% from 2012.

What makes this particularly disturbing is that the need for eye research is more important now than ever, as demonstrated by the infographic below.

Giving to eye research — This infographic by the National Institute of Health (NIH) is used with their permission.

Giving For Eye Research

The eye diseases in the above graphic are related to aging. The number of people being affected is more than doubling for each eye diseases, except for diabetic retinopathy which will increase by 47%, by 2050.

While we are more health conscious than in previous years, knowing the importance of exercise, healthy eating and not smoking, the US population is aging.

Aging baby boomers, the largest population group in US history, are creating a dramatic shift in the age composition of the U.S. population. It is projected that the entire senior population, including the pre-boomer silent generation, will reach 71.4 million people by 2029. This means that those people 65 and older will make up about 20%of the US population by 2029, up from almost 14% in 2012.

We need your help to find treatments and cures for these sight-threatening eye diseases.

December 1st will be the fourth year of #GivingTuesday. It is a global day of giving using combined power of social media and collaboration. Always the Tuesday following Thanksgiving, it has become as widely recognized as Black Friday and Cyber Monday and kicks off the philanthropic season, when many focus on their holiday and end-of-year giving.

We are asking that you support eye research through the Discovery Eye Foundation this philanthropic season with a gift on #GivingTuesday. It is easy to do; you can do it from the comfort of your home – just click here.

Also share this post with family and friends so they can also give the gift of sight this holiday season.

Thank you for reading our blog and for your support.

11/24/15

Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

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Glaucoma

7 Tips for Living With Glaucoma

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Silent Thief of Sight – Glaucoma

Silent Thief of Sight – Glaucoma

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January is National Glaucoma Awareness Month – An important time to raise awareness for this sight-robbing disease.

The Brain and the Eye

Layers of the Retina

Tips for Living With Glaucoma

Silent Thief of Sight – Glaucoma

Why are low-vision aging adults at higher risk for falls?

Giving For Eye Research

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