September is Healthy Aging Month

Healthy Aging Month is an annual health observance designed to focus national attention on the positive aspects of growing older.  Aging is a process that brings many changes. Vision loss and blindness, however, do not have to be one of them. There are several simple steps you can take to help keep your eyes healthy for the rest of your life.

Eye diseases often have no early symptoms, but can be detected during a comprehensive dilated eye exam.  A comprehensive dilated eye exam is different from the basic eye exam or screening you have for glasses or contacts. By dilating the pupils and examining the back of the eyes, your eye care professional can detect eye diseases in their early stages, before vision loss occurs. By performing a comprehensive eye exam, your eye care professional can check for early signs of –

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! Even if you are not experiencing vision problems, visiting an eye care professional regularly for a comprehensive dilated eye exam is the most important thing you can do to reduce your risk of vision loss as you age.

Download “Everyone’s vision can change with age”
A handout with explanation on how vision can change with age.

How to Keep Your Eyes Comfortable During 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.

5 Most Common Eye Problems

Most people have eye problems at one time or another. Some are minor and will go away on their own, or are easy to treat at home. Others need a specialist’s care. Some eye issues come with age while others may be a serious condition.

 

If you’ve never had a problem with your eyes it can be easy to forget how important it is to take care of them. The good news is that it’s never too late to start taking care of your eye health. Regular eye health appointments and eye exams can lead to early diagnosis. This is key to correcting or slowing most eye conditions.  Always see your eye care professional if your vision problem lasts for more than a few days or worsens.

The five most common eye conditions leading to loss of vision or blindness are:

  • Dry Eye
  • Cataracts
  • Diabetic retinopathy
  • Glaucoma
  • Age-related macular degeneration

Dry Eye

Dry eye is a common condition that occurs when your tears aren’t able to provide adequate lubrication for your eyes. Tears can be inadequate for many reasons. For example, dry eyes may occur if you don’t produce enough tears or if you produce poor-quality tears. Dry eyes can also feel very uncomfortable.

Signs and symptoms, which usually affect both eyes, may include:

  • A stinging, burning or scratchy sensation in your eyes
  • Stringy mucus in or around your eyes
  • Sensitivity to light
  • Eye redness
  • A sensation of having something in your eyes
  • Difficulty wearing contact lenses
  • Difficulty with nighttime driving
  • Watery eyes, which is the body’s response to the irritation of dry eyes
  • Blurred vision or eye fatigue

Cataracts

A cataract is a clouding of the lens in the eye that typically will affect your vision. Most cataracts are related to aging. People who have cataracts often have other vision problems in one or both eyes that accompany the cataract, such as nearsightedness (myopia), farsightedness (hyperopia), astigmatism (blurred vision), and/or presbyopia (reading problems).

The lens lies behind the iris and the pupil. It works much like a camera lens. It focuses light onto the retina at the back of the eye, where an image is recorded and sent to the brain. The lens also adjusts the eye’s focus, letting us see things clearly both up close and far away. The lens is made of mostly water and protein. The protein is arranged in a precise way that normally keeps the lens clear and lets light pass through it.

But as we age, some of the protein may clump together and start to cloud the lens. This is a cataract. Over time, the cataract may grow larger or more dense making it harder to see. There are no known medications or diets to prevent age-related cataract so currently the only treatment is cataract surgery. Consult an ophthalmologist for a cataract surgery evaluation.

Diabetic Retinopathy

Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in American adults caused by changes in the blood vessels of the retina.

We know that:

  • Currently more than 4 million Americans aged 40 and older have some form of diabetic retinopathy
  • There is a higher prevalence in African Americans, Hispanics/Latinos, American Indians, and Alaska Natives aged 20 and older
  • Preventive measures help and it is highly treatable.

In some people with diabetic retinopathy, blood vessels may swell and leak fluid or blood inside the eye. In other people, abnormal new blood vessels grow on the surface of the retina. The retina is the light-sensitive tissue at the back of the eye. A healthy retina is necessary for good vision.

Two important tips for diabetic retinopathy prevention: 1) Diabetic retinopathy is worse in patients with poor blood sugar control, so follow your diet and medication prescriptions carefully. 2) Get a dilated eye exam from your ophthalmologist every year for early diagnosis and treatment.

Glaucoma

Glaucoma is a disease that causes damage to the major nerve of the eye called the optic 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.

At age 50 about 2% of the US population has glaucoma, increasing to 4% by age 70 and 10% for those over age 80. While anyone can develop glaucoma, there are some risk factors that increase the likelihood of having this disease, which include:

  • A family history of glaucoma
  • Mexican American heritage over the age of 60
  • African American heritage over age 40.

Often people with glaucoma are unaware they have the disease because there are no symptoms, so it is recommended that you have a dilated eye exam every two years. With early diagnosis there are treatments that can often protect against irreversible damage to the optic nerve that can lead to serious vision loss. Glaucoma can be treated with eye medications, lasers, and various surgical procedures. However, if glaucoma is not controlled can cause debilitating loss of vision.

Age-Related Macular Degeneration

Age-Related Macular degeneration (AMD) is a progressive eye condition affecting as many as 15 million Americans. The disease attacks the macula of the eye, where our sharpest central vision occurs, affecting reading, driving, identifying faces, watching television, safely navigating stairs and performing other daily tasks. Although it rarely results in complete blindness, it robs the individual of all but the outermost, peripheral vision, leaving only dim images or black holes at the center of vision.

As the disease progresses color vision and central vision sharpness deteriorates. the gradual destruction of light sensitive cells continues until large areas are totally gone. Peripheral vision remains, but the ability to clearly see straight ahead and to see color is lost.

For many people, the first sign of macular degeneration is something they notice themselves. Straight lines like doorways or telephone wires may appear wavy or disconnected. When you look at a person, their face may be blurred while the rest of them is in focus. Lines of print may be blurred in the center or the lines may be crooked. For some people, there is a sudden blurring or loss of sight in the center of vision. For any sudden change in vision, you should contact your ophthalmologist immediately.

AMD can be classified into Early AMD and Late AMD. In Early AMD, a patient may have drusen, which are small protein/lipid deposits underneath the retina, and they can still have good vision. In Late AMD, there are two common forms that occur—wet (neovascular AMD) and dry (atrophic AMD). The wet AMD has abnormal blood vessels beneath the retina that leak blood which can greatly distort the vision and cause a central blind spot.  Approximately 10-15% of patients have the wet form. Fortunately, there are treatments for wet AMD.   To date, the dry, atrophic form of AMD does not have any treatments available. In dry AMD, the retinal pigment epithelial (RPE) cells, which are the posterior-most layer of cells in the retina, undergo extensive degeneration that causes the overlying retina to lose function.  We do not know what causes the RPE cells to become unhealthy and start to die.  Many research laboratories worldwide are studying the causes of dry AMD and how to treat it.

Help keep your eyes healthy for years to come with regular eye exams, and treatment at the first sign of a problem.

 

Low Vision Awareness Month

Low vision affects millions of Americans — including many older adults. People with low vision aren’t blind, but because of their vision loss, they may not be able to do everyday tasks like driving or reading even with glasses.

What is Low Vision?

When your eyesight is impaired to the degree that you struggle with daily tasks like reading or cooking – or that you have difficulty recognizing faces, you may have a medical condition referred to as low vision. Someone with low vision can’t simply put on a pair of glasses or contacts and see well; this condition is beyond the typical loss of vision that occurs with aging.

Individuals experiencing low vision can struggle with maintaining independence; hobbies, reading and even socializing may become challenging as vision loss progresses. Because of the impact low vision can have on your life, it is important to have your eyes checked by a low vision specialist if you have any concerns.

Since it is unusual to be able to restore vision once it is lost, screenings can help preserve the vision you have and help you access adaptive lenses and devices if you need them. While there is not a cure for low vision, your specialist can help you adapt and if needed, create a vision rehabilitation program designed to meet your specific needs.

Low vision is often caused by one of these conditions:

  • Age-related macular degeneration (AMD) –AMD is a progressive eye condition affecting as many as 15 million Americans. The disease attacks the macula of the eye, where our sharpest central vision occurs, affecting reading, driving, identifying faces, watching television, safely navigating stairs and performing other daily tasks. Although it rarely results in complete blindness, it robs the individual of all but the outermost, peripheral vision, leaving only dim images or black holes at the center of vision. Read More (link to DEF website)
  • Diabetes Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in American adults caused by changes in the blood vessels of the retina.

In some people with diabetic retinopathy, blood vessels may swell and leak fluid or blood inside the eye. In other people, abnormal new blood vessels grow on the surface of the retina. The retina is the light-sensitive tissue at the back of the eye. A healthy retina is necessary for good vision. Read More (link to DEF website)

  • Glaucoma glaucoma is a disease that causes damage to the major nerve of the eye called the optic 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. (link to DEF website)

  • Injury to the eye can also be a cause

Regular eye exams are essential for all adults; it is recommended that adults over the age of 60 have eye exams each year. For older adults, diabetics and anyone with the risk factors above, a visit with a low vision specialist may be warranted as well. This specialist differs from a conventional optometrist and is trained to detect low vision and offer solutions to help you retain or regain independence and the ability to do things you enjoy again.

While Low Vision Awareness Month is the ideal time to learn about this condition and about the risk factors you could be facing, you should get in touch with a low vision specialist any time you have concern about your eyesight. Any time you notice a change in vision, if you receive a new diagnosis or have one or more of the risk factors detailed above you should schedule an appointment right away.

Low Vision Resources from the National Eye Institute

It can be hard to describe low vision. Visit our website Vision Simulation to see what life is like with common causes of low vision, like age-related macular degeneration, diabetic retinopathy, and glaucoma.

Kids and Sunglasses: Why it’s important!

Due to widespread awareness about the dangers of ultraviolet (UV) rays, most parents have been very cautious about protecting kids’ skin with sunblock, hats and clothing. However, what is usually overlooked is a good pair of sunglasses. 

Children are more susceptible to damage from UV exposure, which can penetrate deep into the eye and can increase the onset of eye problems in the future.  It’s really important we protect their vision, especially because kids spend lots of time outside and their eyes haven’t fully developed yet. More importantly, sunglasses may save their skin and eyes later in life by blocking the sun’s powerful UV rays.  Children under age 10 are at a high risk for skin and eye damage from UV exposure. The skin on their eyelids and around their eyes is more delicate and vulnerable than adult skin. 

UV ray damage builds over time, so the sooner you start protecting your children’s eyes from the sun, the lower their risk will be of ever developing future eye problems.

Here are a few tips to follow to help you find the right sunglasses for your kids:

  • UV Protection – Sunglasses for children should block 100% of UV radiation as well as between 75 – 90% of visible light. Any sunglasses you buy should have this information provided in the packaging 
  • Durability – Kids run, trip and fall. Their sunglasses should match this active lifestyle. Lenses should be made of a high impact material such as polycarbonate to prevent any breakages or scratches. Frames should be bendable but unbreakable. Make sure the glasses fit snugly, close to the face.
  • Spring hinges – Hinges that extend beyond 90 degrees and have a spring action to keep the fit of the frame snug will decrease the risk of your child’s sunglasses falling off or getting damaged during sports and other play.
  • Let them choose – You’re not the one who has to wear the glasses or hear other kids’ comments on them. Children and especially older kids/teens – are likelier to actually wear them if they select them themselves.
  • Fit & Comfort – Children’s sunglasses should offer good eye coverage and fit comfortably. Allow your child to try on various pairs to find something that is comfortable and fits correctly.
  • Set an Example – Kids at a young age look up to their parents so set a good example! Ensure you’re wearing your sunglasses every time you go outside if you want your child to do the same.

If your child has prescription sunglasses, be sure they are made with UV blocking clear lenses. You can get them a second pair with tinted polycarbonate lenses, or you can get photochromic lenses that change from light to dark to avoid having two pairs.

Sunglasses do not have to be expensive.  Many inexpensive children’s sunglasses provide excellent UV protection because they include polycarbonate lenses which blocks 100 percent of UV.

Beware because some cheap brands of sunglasses for children can include an unacceptable level of lead and usually are not durable or as high-quality as other sunglasses.

Start with an eye exam – because children’s eyes change so rapidly, make sure your child is seeing well.  Children who do not need vision correction should have an eye exam at least every two years.  Children who need glasses or contact lenses should have an eye exam annually or as recommended by your eye doctor.

 

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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.

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

women's eye health
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.
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  • 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.
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  • 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.
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  • 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.
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  • 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.
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  • 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 DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Wearing Contact Lenses in Winter

Wearing Contact Lenses in Winter This has been a cold winter so far, and since it is only January, it is bound to get colder. The extreme cold, combined with winds, snow, rain and other environmental factors, can really take a toll on your eyes. And while it may be snowing or raining, winter air is actually drier than any other season. This can be especially difficult if you wear contact lenses. Here is what you should know about wearing contact lenses in winter.

  • Wear sunglasses for protection from UV rays and wind. Your eyes can become sunburned which cause blurry vision and can make your eyes feel like they are burning (think of your sunburned skin feels) for 24 to 72 hours. It will also protect your eyes from snow, rain or anything else the wind can send your way.
  • Avoid direct sources of heat such as heating vents and fireplaces. Indoor heating can draw the moisture out of the air, so consider a humidifier to help maintain the correct amount of moisture in the air to help keep eyes moist. Cool-air humidifiers have less of a tendency toward mold and bacteria.
  • Speaking of hydration, we also tend to drink less water in the winter months, so make a concentrated effort to keep up your water intake.
  • If it is so dry, why are my eyes watering? This is a common question and the answer may be a bit counter-intuitive. Anything that irritates your eyes, including dryness, causes a tearing reflex. Your tear glands go into overdrive trying to replace the moisture to your cornea. To try and reduce the tearing, you can use eye drops or artificial tears specifically designed for use with contact lenses.
  • Your eyes are not the only thing that dries out in the winter, so does your skin. Try to put in your contacts before moisturizing your skin, especially your hands. So wash your hands, put in your lenses and then use your creams and lotions.
  • Change out your contact lenses regularly in cold weather according to the recommended schedule, be it daily, every two weeks or monthly. This will allow them to better conduct oxygen, reduce irritation and increase comfort.
  • Take a break from your contacts and wear your eyeglasses. Putting them on when you get home from work can make a big difference. Contact lenses dry your eyes out on their own, when you add cold weather it gets that much worse.
  • Get plenty of sleep, which also helps with the dryness and fatigue. This will help you start the day with your eye refreshed and ready for the many things you will put them through throughout the day ahead.

Do you have any other suggestions that have helped you cope when wearing contact lenses in winter?

1/15/16


  Susan DeRemerSusan DeRemer, CFRE Vice President of Development Discovery Eye Foundation

Smoking and Your Eyes

Smoking is the single largest preventable cause of eye disease.
smoking and your eyes
On the third Thursday of November each year, smokers across the nation take part in the Great American Smokeout, sponsored by the American Cancer Society. This might be the ideal time for you to stop smoking and ACS has information and resources you may find helpful.

Here are some things you should know about smoking and your eyes.

  • Smoking at any age, even in your teens or twenties, increases your future risk for vision loss.
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  • The more you smoke, the higher your risk for eye disease.
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  • If you quit smoking, your risk for these eye diseases decreases considerably.
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  • Smoking increases your risk for cardiovascular diseases that indirectly influence your eyes’ health.
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  • Women who smoke during pregnancy increase their chance for a premature birth and a potentially blinding eye disease called retinopathy of prematurity (ROP).
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  • A smoker is two times more likely to develop macular degeneration compared with a nonsmoker.
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  • Smoking double your chance of forming cataracts and the risk continues to increase the more you smoke.
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  • Smoking doubles your diabetes risk which can lead to the blinding eye disease, diabetic retinopathy.
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  • Smokers are more than twice as likely to be affected by dry eye syndrome as a non-smoker.
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  • Second-hand smoke also makes dry eye worse, especially for contact lens wearers and post-menopausal women.
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  • If you smoke you can have a three-fold increase in the risk of developing AMD compared with people who have never smoked.
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  • Smoking appears linked to the development of uveitis with smokers having more than twice the risk of non-smokers.

If you are looking to stop smoking you may also want to check out Smokefree.gov which provides free, accurate, evidence-based information and professional assistance to help support the immediate and long-term needs of people trying to quit smoking.

11/19/15

Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Treatments for Dry Eye Disease

This is the third and final installation of the comprehensive series we have presented on dry eye disease. Dr. Wade first discussed the symptoms you might experience if you have dry eye and the Dr. Garg explained the process of diagnosing they type of dry eye disease you might have. In this article Dr. Farid reviews treatment options based on your diagnosis of dry eye disease.treatments for dry eye

Treatments for Dry Eye Disease

As our understanding of dry eye disease expands, so do treatment options. We now know that dry eye disease is a multifactorial disease. There is no one cause so there is no one magic cure. Treatments aim to improve tear composition, reduce eye surface inflammation, and target eyelid margin disease. Here, we will review many treatment options, but the treatment combination or “cocktail” that is appropriate for you will depend on your specific type of dry eye disease. This is usually determined after some testing by your eye care provider.

Environmental, Dietary, and Medication Adjustments
Before going into specific dry eye treatments, there are modifiable causes and preventative methods to improve dry eyes. Simple changes in the environment, diet, and medications can be easy ways to improve symptoms.

Environmental Changes
As expected, a dry environment will worsen dry eyes. Humidifiers and moisture goggles have been shown to help alleviate these symptoms. Furthermore, situations that cause decreased blinking, such as prolonged use of computer screens, can worsen dry eyes. Patients should take frequent breaks from computer screens and reading, allowing their eyes to rest and resume normal blinking. When in windy, smoky, or dusty situations, sunglasses can act as a barrier to the eyes, reducing dry eye symptoms. Avoiding wind, fans, or any source of air blowing into the eyes may also help.

Dietary Changes
Drinking adequate water keeps patients hydrated and reduces exacerbations of dry eye symptoms. Omega-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have been shown in many clinical studies to improve dry eyes. It is believed that these fatty acids help inhibit inflammatory mediators. Essential fatty acids cannot be synthesized and must be ingested through diet. Foods rich in omega-3 fatty acids include fish, other seafood, and flaxseed oil. Supplements are also available.

Adjusting Medications
Many medications are associated with dry eyes, and patients may benefit from adjusting doses or finding alternative treatments. You can work with your physician to weigh the costs and benefits about modifying your current medications if they are suspected to worsen dry eyes. Some of these medications include: hypertensive drugs, antihistamines, decongestants, antidepressants, acne medications, birth control, and hormone replacement therapy. Eye drops with preservatives, such as glaucoma medications, can also worsen dry eyes.

Lubricating Treatments
For patients with decreased tear production, supplementation of tears or reduction of tear drainage will improve symptoms.

Artificial tears, gels, and ointments
Artificial tears, gels, and ointments are readily available over the counter. Artificial tears are eye drops that are used throughout the day as needed, up to eight times for dry eyes. You must make sure to get “lubricating” drops. There are multiple available brands that are excellent and equivalent in providing artificial moisture. Avoid “redness relief” brands as they are focused on reducing appearance of the vessels in the eyes as opposed to actual dry eye relief. Gels and ointments are thicker and very effective but can blur vision. Non-commercial comparison testing between brands has not been done. Because the ingredients, preservatives, and consistency vary from brand to brand, it is recommended for patients to choose the best option that works well for them based on trial and error.

Preservatives are used in many eye drops to help them to last longer. Unfortunately, they can be irritating to the eyes, especially when used often (more than 4 drops/day) or with other drops containing preservatives (ie. glaucoma medications). Patients who frequently use eye drops are recommended to use preservative-free (PF) drops. Unfortunately, preservative-free drops are more expensive because they come in “single use” containers. You may be able to extend the life of each single use container by spreading out its contents over multiple uses throughout the day.

Lipid-containing lubricants, such as those with castor oil, attempt to mimic the oils found in the tears, reducing evaporative dry eyes, but more research is necessary to study their efficacy.

Punctal Plugs
Your ophthalmologist can place small plugs at a clinic visit into the punctum, a small hole at the upper and inner lids that drain tears from the eyes. One plug can be added initially, and if more tear retention is required, another plug can be added. There are absorbable and non-absorbable types. Absorbable types are made of collagen and last 1 week to 6 months. Once placed, they are not visible or removable. Non-absorbable plugs are usually silicone, and permanent. They are easily placed by your ophthalmologists and remain visible in follow-up exams. Some patients feel the plugs, and there may be mechanical rubbing, especially when the plug is not the proper size. Some patients may also experience excessive tearing with plugs. If problematic, patients can wait for the plugs to dissolve if absorbable or they can be removed with forceps if non-absorbable.

Autologous Serum
Serum is extracted from a patient’s blood and turned into an eye drop. The growth factors, vitamins, and antibodies present in serum are the same as those in natural tears. Evidence is showing significant promise in alleviating symptoms and signs of chronic dry eye disease. A good collaboration between a phlebotomy lab and compounding pharmacy is necessary to make the products. The products must be kept refrigerated or cold between uses. They can be frozen for long-term storage. Each blood draw provides a supply of drops that can last 3-6 months.

Hydroxypropyl Cellulose Ophthalmic Inserts (Lacrisert)
An insert is available for people who find regular artificial tear use to be difficult. A physician can order the inserts through a pharmacy. The patient places the insert in the inferior fornix of the eye, the area between the lower lid and sclera of the eye. It slowly dissolves over 24 hours, giving constant lubrication.

Anti-inflammatory Treatments
Inflammation is now being recognized as a major underlying cause of chronic and worsening dry eye disease. Many patients who have been suffering from chronic dry eyes, particularly those with autoimmune diseases like Sjogren’s Syndrome, will do well on treatments that reduce the amount of inflammation in the tear film and ocular surface. Your physician can order these medications for you if needed.

Cyclosporine A (Restasis)
The FDA approved Restasis for dry eyes in 2002. This is an immunosuppressive and anti-inflammatory eye drop medication. Relief is not instant, and may take 6-8 weeks of sustained use for improvement in dry eye symptoms. Less than 20% of patients may experience a burning sensation with the drops, but the safety and tolerability profile is otherwise excellent.

Antibiotics
Doxycycline and minocycline are used for inflammatory ocular surface and eyelid disease. The antibiotics have a dual effect: they act as anti-inflammatories and anti-microbials. As an anti-microbial, these medications can improve meibomian gland function. They can decrease lid bacterial flora, reducing a cause of meibomian lipid breakdown. A low-dose (doxycycline 20 mg BID) regimen for 1-2 months has been shown to be effective. Side effects are usual mild but include stomach upset, yeast infections, and photosensitivity.

Steroids
Steroids act as anti-inflammatories. Because steroids are associated with complications in long-term use, they are mainly used in short pulses either at the initiation of treatment or as rescue during exacerbations. A short 4-6 week course is generally well tolerated as a “rescue treatment,” or an urgent treatment, to relieve intolerable symptoms quickly before resorting to other treatment options.

Meibomian Gland Treatments
Meibomian glands produce oils that are crucial in preventing our tears from evaporating too quickly. Treatments that target the glands can help patients with meibomian gland dysfunction or lid margin disease.

Warm compresses and lid scrubs
Warm compresses provide heat that warms the oils in the glands, unclogging the glands and improving oil flow. Warm washcloths, small rice bags heated in the microwave, or commercial hydrogel pads are all effective, and no studies have been done to compare the different methods. The heat. The compress should be placed over the eyes for 5-10 minute. Gentle circular or rolling massage of the eyelids can help express the oils from the glands.

Lid scrubs are useful particularly in cases of blepharitis, or mild inflammation of the lids, that cause them to become crusted. There are excellent over the counter commercial lid soap formulations that work well to clean the lid margins. Alternatively, baby shampoo and a washcloth gently applied to the lids can work as well.

Thermal pulsation (Lipiflow)
Lipiflow is an FDA approved in-office treatment for meibomian gland dysfunction and dry eyes. During the 12-minute procedure, a device is placed over the eye and eyelids that provides localized warmth and pressure on the lids (Figure 1).

treatments for dry eye
Image 1 – Lipiflow treatment

The procedure is 100% safe and very effective at clearing out the trapped oil glands and allowing smooth flow to be re-established. After approximately one month, the consistency of the oils in the tear flow will have improved remarkably with associated improvement in dry eye symptoms. With one procedure, the effects last between 12-24 months.

Intense Pulsed Light (IPL)
Originally approved for acne and rosacea dermatologic disease, IPL uses bursts of light to minimize blood vessel size. It can be used off-label for ocular rosacea and meibomian gland dysfunction, but results have not been reported.

Summary
There are many treatment options for dry eye disease. Generally, conservative over-the-counter treatments should be tried first. Commonly, environmental changes, dietary changes, artificial tears, and warm compresses will improve the majority of dry eye symptoms to tolerable levels. However, when these options are exhausted, there are many additional options for patients. Work closely with a trusted health professional to determine the optimal treatment combination as each patient is different.

8/25/15


treatments for dry eyeMarjan Farid, MD
Director of Cornea, Cataract, and Refractive Surgery
Vice-Chair of Ophthalmic Faculty
Director of the Cornea Fellowship Program
Associate Professor of Ophthalmology
Gavin Herbert Eye Institute, University of California, Irvine

 

 

treatments for dry eyePriscilla Q. Vu, MS
Medical Student
University of California, Irvine School of Medicine