Stem Cells 'patch' damaged eyes

The UK's Daily Mail (5/28, MacRae) reports that researchers from Australia's University of New South Wales "have used contact lenses coated in stem cells to restore sight to patients suffering a blinding disease," with the "groundbreaking operation" bringing "significant improvements in vision within a matter of weeks." The new "procedure uses a person's own cells to heal damage to the cornea --- the transparent outermost layer of the eye," and is "carried out under local anesthetic, with patients returning home within two hours of surgery, removing the need for expensive hospital stays." The three patients who have been "treated so far had very poor vision caused by corneal disease -- the fourth most common form of blindness, affecting around 10 million worldwide." Corneal blindness "is caused by genetics, surgery, burns, infection or chemotherapy, and treatments usually include grafts and transplants, and drugs, such as steroids."
The UK's Telegraph (5/28, Alleyne) adds, "If early findings bear out, then the treatment could be effective for thousands of patients in Britain, and is so cheap it could be used for millions more in the Third World." In the procedure, the investigators "removed tissue with regenerative stem cells from patients' own eyes and then multiplied them in the laboratory on the surface of a contact lens." Next, the contact lens "was...placed back onto the damaged cornea for 10 days, during which the cells, which can turn into any other sort of cell, were able to recolonize and 'patch' the damaged eye surface." The Australian (5/28, Dayton) and Australia's The Age /AAP (5/28) also cover the story. (courtesy AOA)
It is exciting to see advancements in eye care coming. We are no where near the Minority Report when it comes to what we can do surgically but I am glad that people are still working hard to improve medical care.

There are risks involved in LASIK

Dow Jones Newswires (5/23, Favole) reported that in a letter issued May 22, the Food and Drug Administration (FDA) said that "doctors need to give patients detailed information about the risks associated with" laser-assisted in situ keratomileusis (LASIK) eye surgery. The FDA "sent a letter to doctors requesting that they tell patients about risks associated with LASIK...after receiving numerous complaints from consumers who experienced double and fuzzy vision and painful dry eyes after getting the procedure." In April 2008, the "agency held a public meeting" during which "consumers expressed concerns about risks associated with the surgery." The agency "said it believes 'eliminating deceptive or misleading' health" advertisements "is an important part of protecting the public's health."
Reuters (5/23, Heavey) added that the current recession has had an impact upon LASIK procedures, which can cost several thousand dollars per eye and are, in most cases, not covered by health insurance. (couretsy AOA)

An alternative to LASIK is orthokeratology. It is non-surgical and therefore does not carry the same risks that surgery does. Orthokeratology does not exacerbate dry eyes because it does not damage the nerves that regulate tear production. It is reversible and adjustable for those who may experience double or fuzzy vision from the procedure. An added benefit is that it costs about 1/2 the cost of LASIK.

Eye excercised don't improve vision

A recent news article examined the validity of doing eye exercises to improve your vision. The claims range from improving your sight, eliminating glasses through eye exercises etc. One company involved in this, the "See Clearly Method" has been taken off the market for false advertising. A recent study indicates that there is little scientific evidence to support these claims.

That being said, vision therapy, a doctor prescribed system of vision exercises can help. They will not reduce myopia or prevent presbyopia but it can help with problems is focusing, eye teaming and eye tracking. You can learn more about vision therapy here.

Vision problems in children are often undiagnosed.

On its website and on the air, WJZ-TV Baltimore, MD (5/21, 6:31 p.m. EDT, Lynn), a CBS affiliate, reported that "a study out of Johns Hopkins Children's Center," which was "funded by the National Eye Institute," found that "although vision problems are rare among urban preschoolers, many children with easily treatable problems are not being diagnosed." In the "study of nearly 2,300 children," researchers "found five percent had a defect in the eye's ability to focus light, but only one percent were treated." Study author Michael Repka, MD, attributed the lack of treatment to "lack of access." Dr. Repka explained, "There are no structured programs that are available in the community, to look for refractive errors." He added, "An uncorrected refractive error can lead to permanent visual loss." According to WJZ-TV, "the study should serve as a reminder for parents of children between the ages of three and four to ask their pediatrician for an eye chart exam."

Controling diabetes helps with complications

HealthDay (5/20, Thompson) reported that new research demonstrates the importance of "keeping blood glucose levels at a normal, low level" when "it comes to avoiding the complications of" diabetes, "which can include eye, kidney, and nerve damage." For the study, Swedish researchers analyzed "patient records at diabetes clinics in Sweden and also" included data from "a large American study." By using "new statistical methods" to analyze "the large amount of data," the team found it "possible to study the treatments' effectiveness over long periods of time." Study author Marcus Lind, MD, who presented the study, stated, "Our results show that the risk of complications 10 to 15 years after the start of treatment probably decreases significantly following even small improvements in blood glucose control." Dr. Lind continued, "If the treatment of all Swedish diabetes patients could be even slightly improved, we believe that tens of thousands of cases of injuries to the eyes, kidneys, heart, nerves and brain could be prevented."

Electronic Records are costly

The CBS Evening News (5/19, story 12, 3:05, Couric) reported, "Experts say one way to reduce mistakes is to make all medical records available by computer, but that has a high cost, too, and not all doctors are ready to pay it." CBS' Wyatt Andrews notes that "President Obama put $20 billion in the stimulus for computerized records saying they'd save money and lives and get done in five years." Andrews adds that "there is plenty of evidence electronic records save lives," but "savings from electronic records are much harder to prove." He notes that "high costs are the biggest obstacle facing the electronic future."
Study suggests patients expect EMRs to figure heavily in their care. Healthcare IT News (5/19, Merrill) reported that a study conducted by researchers at the Beth Israel Deaconess Medical Center reveals that "patients are open to having electronic medical records (EMRs) play a more central role in their care." In fact, they "want full access to all of their medical records, are willing to make some privacy concessions in the interest of making them transparent, and fully expect that computers will play a major role in their medical care, even substituting for face-to-face care." Lead investigator Jan Walker "said patients not only want computers to bring them customized medical information, but fully expect to be able to rely on electronic technology in the future for many routine medical issues." These findings are the results of "focus groups in Boston, Portland, Maine; Tampa, and Denver," locations that were "selected to represent various geographic areas...and incorporate ethnic and cultural diversity." (courtesy AOA)

LASIK and orthokeratology are two alternatives

I ran across this interesting article written by Murat V. Kalayoglu, M.D., Ph.D. This was one of the comments that he made.

"Clearly, orthokeratology is not for everyone. However, neither is LASIK. Each patient should choose the right treatment after considering various criteria and alternatives, which are best teased out with the help of their Eye M.D. And maybe, just maybe, the best alternative is to keep wearing those eyeglasses!"

I like the wisdom in that. When choosing a correction option for your eyes be sure to do your homework. Realize what the risks and benefits are of the various options. Recognize what you are comfortable with and trust your doctor to inform you whether you are a good candidate for procedures such as LASIK and orthoekeratology.

An article on orthokeratology

I found a great article on orthokeratology online that is worth reading. It explains how orthokeratology works, potential side effects, a brief comparison to LASIK, estimates of cost etc. I still think one of the greatest advantages is for children who can be correction free during the day. Check our the article here.

Multifocal lens options for Cataract Surgery

The New York Times (5/15, Jaret) updated its Times Essentials: Reporter's File section on cataracts, which can "occur when the eye's natural lens becomes cloudy with age." While "cataracts don't harm the eye," they "can progressively impair vision." During cataract replacement surgery, "cloudy lenses can be removed and replaced with artificial lenses designed to correct a range of vision problems." Currently, "patients can now choose from a wide range of artificial lenses." While "monofocal lenses, which have long been in use and are covered by insurance, remain the most common choice of replacement lens," now "multifocal lenses are growing in popularity." But, "because these so-called premium lenses are not considered medically necessary, they aren't covered by Medicare or private insurance," and "the additional cost can run up to $3,000 per eye." Yet "another new artificial lens design, called a toric lens, corrects astigmatism, which is caused by an abnormal curvature of the cornea." They too "are considered premium lenses and aren't covered by most insurance plans."(courtesy AOA)

Orthokeratology Video

Diet can affect risk of Macular Degeneration

In the New York Times (5/7) Well blog, Tara Parker-Pope observed that, according to a study published in the May issue of Ophthalmology, "eating a diet rich in leafy vegetables, nuts, and fish and low in starchy carbohydrates appears to lower risk for age-related macular degeneration (AMD), the leading cause of severe vision loss in people over 50." For the study, researchers from the Tufts University Jean Mayer USDA Human Nutrition Research Center on Aging collected data "from 4,003 participants in the ongoing Age-Related Eye Disease Study." The investigators found that "the dietary nutrients linked with lower risk for macular degeneration are vitamins C and E, zinc, lutein, zeaxanthin, and the omega-3 fatty acids known as DHA and EPA. Notably, the nutrient often associated with eye health, beta carotene, was not linked with lower risk for macular degeneration," and "the greatest benefit was seen among participants who regularly consumed a combination of the protective nutrients as part of a low-glycemic index diet."(courtesy AOA)

Lucentis can help with wet AMD

MedPage Today (5/6, Susman) reported that, according to a study presented at a vision research meeting, "the ability to read a newspaper or even prepare a meal -- functions that require near-vision abilities -- appear to improve when patients with the 'wet' form of age-related macular degeneration (AMD) undergo treatment with ranibizumab (Lucentis)." For the study, researchers at Sweden's Linkoping University recruited 30 patients. After using ranibizumab, the patients "achieved a 50 percent improvement in their ability to read newspapers and a 30 percent improvement in all types of near-vision activities." The authors concluded that "ranibizumab offers a most valuable treatment for wet" AMD. Emily Chew, MD, of the National Eye Institute, who was not involved with the study, "noted that while the ability to perform near activities improves quality of life, treatment with drugs such as ranibizumab also control eye disease and can prevent progression of age-related macular degeneration." (courtesyAOA)