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The Human Drama

All of us are players in the human drama, and there are moments when we get to observe it up close and very personal. I was in Chicago, preparing to speak in an ophthalmology practice. As I often do, I arrived early to sit in the waiting area and work to get a feel for the energy and style of the practice. I didn’t mean to overhear their conversation, but as I listened, I was deeply touched by their love and in that moment, their fear.

I learned that Charlie was 88 and Rose was 86. I am sure they were holding hands as Rose was saying “Oh, Charlie, I am so sorry about the falls I have had. I just can’t see the step from the kitchen into the family room.”

Charlie tried to comfort her. “It’s alright Dear, the Doctor will give us the answers, and I am sure you’ll be better.”

I didn’t speak to Charlie over the next 40 minutes believing that I would be intruding but sure that he was living every second of the exam going on just a few steps away.

When Rose exited the Doctor’s office, she was supported by the Doctor and a Tech who must have been holding her up because she collapsed into her husband’s arms.

“I’m sorry,” she kept saying. “I am sorry Charlie. It’s Macular Degeneration. And, the Doctor says there’s very little he can do for me.”

I could hear Charlie rubbing his wife’s shoulders and telling her that everything would be alright. But, Rose kept saying “I know we’ll have to sell the house and move into something smaller, and I am going to be blind Charlie. Blind.”

Moments like this are happening across the country in ophthalmology and optometry practices every day. 30% of adults, age 60 and older, suffer from this horrible disease, and only through research will answers be found.

The Discovery Eye Foundation is committed to finding those difficult answers and making it possible for people like Rose to see the faces of loved ones for many years to come.

Tom Sullivan
DEF’s Ambassador of Vision
sullivanvision.com

September is Healthy Aging Month

Today, people are living longer than ever before so it’s important to be proactive and take responsibility for your health as you age.

Like any other organ in your body, your eyes do not stay the same as you get older. Vision changes are normal with age but vision loss and blindness are not. Older adults are at higher risk for certain eye diseases and conditions, including age-related macular degeneration, cataract, diabetic retinopathy, glaucoma, dry eye, and low vision. To continue to enjoy healthy vision as you advance in years, it’s important to have a comprehensive dilated eye examination with an ophthalmologist or optometrist on a regular basis.

Here are some other tips to maintain healthy vision now and as you age:

Eat a healthy, balanced diet. Fruits and vegetables can help keep your eyes healthy. Visit our website for healthy eye recipes, click here Eye Cook.

Maintain a healthy weight. Being overweight increases your risk for diabetes. By exercising regularly, you can help keep your body healthy and prevent vision loss.

Don’t smoke. Smoking increases your risk for age-related macular degeneration, cataract, and other eye diseases and conditions that can damage the optic nerve.

Wear protective eyewear when outdoors. Protecting your eyes from the sun’s ultraviolet rays when you are outdoors is vital for your eye health. Wearing sunglasses that block 99 to 100 percent of both UV-A and UV-B radiation.

Know your family history. Talk to your family members about their eye health history. It’s important to know if anyone has been diagnosed with a disease or condition since many are hereditary, such as glaucoma, macular degeneration, and diabetes . This will help determine if you are at higher risk for developing an eye disease or condition.

Consider a multivitamin. Vitamins C, E and the mineral zinc have been shown to promote eye health. Vitamins with Lutein and Zeaxanthin have been known to help patients with moderate to severe age-related macular degeneration.

Give your eyes a rest. If you spend a lot of time at the computer or focusing at any one distance, you sometimes forget to blink, resulting in dryness and eye fatigue. Every 20 minutes, look away about 20 feet in front of you for 20 seconds. This can help reduce eyestrain. Consider using a lubricant eye drop during long periods of intense eye use and rest your eyes for 5 minutes.

You can’t stop time, but you can take care of your eyes so that they remain healthy as you age. Having a healthy vision can be possible at any age!

A Second Vision

For the last few years Kristin McDonald, a former actress and television spokeswoman, has been applying her make-up without the aid of her eyes due to retinitis pigmentosa, a condition that reduces a person’s peripheral vision until all that is left is a pinpoint of sight.

Today, she is in a first stage study that is offering her and others hope that the injection of stem cells might be the mechanism that could slow, and maybe even halt the effects of this horrible disease. Discovery Eye Foundation helped support many of the preliminary translational studies necessary to bring the clinical trial to the FDA and get this exciting, novel approach to the patients.

I am Tom Sullivan, Ambassador of Vision for the Discovery Eye Foundation, and I was rocked when my phone rang recently and I heard the sound of my friend Kristin crying.

“What’s the matter?” I asked with real concern.

Her tears were quickly replaced by laughter, joyous laughter.

“It might be working,” she said, “I mean, the cells just might be having an impact.”

“Meaning your feeling change in your vision?” I asked.

“Tom,” she went on, “you won’t believe it. This morning when I was getting dressed and putting on my make-up, I saw my mascara in the mirror. Listen, I am not trying to tell you I can see, but since the cells were injected, I can focus on a light and even begin to notice shadows.”

“And, now,” she laughed again, “maybe I can put my mascara on straight!”

Kristin has no illusions about how far the injection of cells will take her; but, she is encouraged, as are many of the other patients who are part of Dr. Henry Klassen’s clinical study helped by DEF’s early stage funding. Maybe the old phrase really does apply – you probably know the one I mean – “hope springs eternal in the human breast.” That goes for the researchers, the patients, and all of us who treasure the gift of sight.

To read more about Kristin McDonald, visit her website at secondvision.net

Tom Sullivan
DEF’s Ambassador of Vision
sullivanvision.com

Get Fit for Your Vision

It’s no secret that exercise is the best way to get in shape and to prevent serious health conditions. But did you know that you can actually exercise your way to healthy eyes too!?

Like your heart, brain, and lungs, your eyes are impacted by how you care for your body. By eating a healthy diet and exercising regularly, you can help prevent eye conditions linked to obesity and being out of shape.

Studies have found connections between regular exercise and reducing risks for several common eye ailments such as cataracts, age-related macular degeneration and glaucoma. Vision problems and eye disease also stem from high blood pressure and high cholesterol. A healthy diet and regular exercise are two of the most important steps you can take to lower both.

What you should know about the common eye diseases and exercise

Cataracts – Studies have found that a lack of physical activity may be associated with an increased risk of getting cataracts. Whether it’s a brisk walk around your block or a run through the park, both activities may be associated with decreased risk of age-related cataract.

Age-related Macular Degeneration (AMD)– Studies found that that those who were active and exercised three or more times a week were less likely to develop AMD.

Glaucoma – Doctors treat glaucoma by lowering high intraocular (eye) pressure. Research that focused on young adults found that moderate intensity, low-impact exercise led to significant reduction in eye pressure. Regular, ongoing exercise, such as walking or jogging, will help reduce eye pressure.

How to kick off your exercise routine

Start simple and set realistic goals. Keep a log of your goals and daily exercise routine, this will help you stick to your plan and track your progress.
Keep it fun.
Mix up your fitness routine with combinations of strength and cardio.
Not feeling all that motivated? Try jump-starting your fitness routine with a little Zumba or ballroom dancing; these are super fun ways to get in shape.
Head outside and roller skate, bike, or go on a hike—all are great calorie burners too.
If it’s too cold to go outdoors, pick up the latest yoga fitness DVD and create a calming atmosphere in your living room. Or you could try a circuit training fitness DVD for a more upbeat cardio workout.
Don’t get stuck in a rut: change up your routine frequently to get the biggest bang out of your exercise time!

No time for exercise? You can squeeze it in between everyday tasks such as:

Taking the stairs at work instead of the elevator.

Walking to your co-worker’s desk instead of sending an e-mail.

Doing lunges or squats while brushing your teeth.

Contracting and holding your abs while working on your computer – try for 10 contractions every hour.

Taking the dog for a long walk or jog—try doing a few lunges on the trail.

Stay active, get plenty of exercise and keep a healthy diet. When you’re tempted to slack off, or quit exercising all together, just remember how terrific you’ll look and feel when you keep moving. You’ll probably agree it’s worth working out a few minutes each day to reap the rewards of good health and great vision!

Click here for Eye Healthy Recipes.

Who’s On First For My Eye’s

The Difference Between an Optometrist and an Ophthalmologist

There are a number of players on your eye-health team, among them your optometrist and your ophthalmologist. It’s not always obvious, however, what position each plays and when you should call on which professional.

Optometrists

An optometrist holds a doctor of optometry (OD) degree. An optometrist generally completes a four-year college program in the sciences, plus four years of postgraduate professional training in optometry school.

Optometrists examine eyes for vision and health problems, and correct refractive errors with glasses and contact lenses. Some optometrists also provide low vision care and vision therapy. In the United States, optometrists may prescribe medications to treat certain eye problems and diseases, and their scope of care can differ by state. While not licensed to perform eye surgery, optometrists can play a role in pre- and post-operative care, if you have eye surgery performed by an ophthalmologist.

Ophthalmologists

An ophthalmologist is a medical doctor (MD) or a doctor of osteopathic medicine (DO), who specializes in eye and vision care. Ophthalmologists complete four years of college, four years of medical school, one year of internship and at least three years of residency in ophthalmology. Some ophthalmologists also have one or two years of additional training to become specialists in cornea, retina, glaucoma, oculoplastics, pediatrics or neuro-ophthalmology.

Ophthalmologists perform eye exams, diagnose and treat diseases, prescribe medications and perform eye surgery. They also prescribe corrective lenses.

Which one do I call?

Both optometrists and ophthalmologists perform routine eye exams, and are both trained to detect, diagnose and manage eye diseases. Both can prescribe corrective lenses, and both must fulfill continuing education requirements to maintain their licenses.

If your eyes are healthy, which type of professional to see is a matter of personal preference. If you already have a medical eye problem, such as diabetes, or a family history of AMD or glaucoma, you should consider seeing an ophthalmologist. While most optometrists offer medical treatment for common eye problems and chronic eye diseases, such as pink eye, dry eye or allergies, certain eye disorders require treatment by an ophthalmologist, particularly if you need surgery, laser therapy or other specialized care.

In some cases, your optometrist and ophthalmologist may work as a team. In such a setup, the optometrist is the equivalent of your primary-care doctor, who monitors your ongoing condition and care, and the ophthalmologist is your specialist, who manages your condition medically and/or performs surgery. For routine care, you may want to check with your insurance provider to see which, if either, professional they cover and for what services.

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.

Your Vision is Your Wealth

We see more than 24 million images in our average life span. The huge task in a human body is seeing, which requires half of one’s brain to function. Our eye lenses are equal to 576 megapixels Camera lens.

One man out of every twelve men is color blind and the chances of losing eye function increase with age. In the UK 74% of people correct their eyesight by Laser Surgery, Wearing Contact lens and glasses to have a better view. Our eyes take only 48 hrs to repair from a corneal scratch. In order to avoid these problems, restrict the continuous usage of contact lens less than 19 hours in a day.

For a better understanding, read this infographic from Paul Gill Optician.

Source and Author:
Amy Lynn
Paul Gill Optician

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

Drugs to Treat Dry AMD and Inflammation

12/2/14

Below is an article from the monthly Macular Degeneration Partnership E-Update on potential drugs to treat dry AMD and inflamation. To learn more about dry AMD, including stem cell treatments, go to AMD.org. You can also subscribe and have the monthly newsletter delivered to your inbox.

There are many causes of age-related macular degeneration and any of them may prove a good target for treatment for dry AMD. A long list of these was discussed at the recent Academy of Ophthalmology meeting. They were divided into the types of drugs being studied. We’ll look first at inflammation and the complement factor system, which is part of the immune system.

Inflammation is known to be associated with macular degeneration. The target may be the inflammation itself, or the cause of the inflammation.

Lampalizumab (or anti-Factor D) is a drug that is injected into the eye. In earlier Phase II trials, it was shown to reduce the area of the geographic atrophy by 20%. A Phase III clinical trial is now underway for individuals with geographic atrophy from dry AMD. Several research sites are actively recruiting now and many others will start recruiting in the near future. For more information and a list of participating centers, visit Clinical Trials.

LFG316 is also an antibody and an injection. This Phase 2 study is a randomized clinical trial of a drug that targets the C5 complement pathway (part of our immune system). It is designed to test the safety and efficacy of different doses of LFG316. There are three arms in the study: one group receiving a higher dose of the drug; one group receiving a lower dose of the drug; one group receiving a sham injection (no drug). These are successive monthly injections for people with geographic atrophy (GA). It is taking place in multiple locations throughout the U.S. and is sponsored by Novartis. For more information and a list of participating centers, visit Clinical Trials.

Oracea is a pill for dry macular degeneration, now in Phase II/III clinical trials around the U.S.. The pill contains doxycyline, which suppresses inflammation. Participants will be randomly assigned to either receive the drug or a placebo. More information at Clinical Trials.

Zimura by Ophthotech has been tested as a drug for wet AMD, but also seems to affect the drusen of dry AMD. Zimura targets the complement pathway plays a significant role in dry AMD. A Phase 2/3 clinical trial investigating ZimuraTM for treatment of geographic atrophy, is in the planning stages.

Eculizumab was also presented. This intravenous treatment for dry AMD did not show the desired effect in clinical trial, so no further development is planned at this time.

POT-4 is another drug that targets the complement factor system involved in inflammation. It is delivered through injection into the eye. The Phase I trial is completed and a Phase II clinical will be announced soon.

Iluvien is a drug delivery system that has been used in patients with diabetic retinopathy. A Phase II clinical trial for dry AMD is underway, though it is no longer recruiting patients. This is an implant inside the eye that releases fluocinolone acetonide. For more information, see Clinical Trials.

Judith Delgado
Executive Director
Macular Degeneration Partnership
A Program of the Discovery Eye Foundation

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