A video explaining orthokeratology

UV rays can cause skin cancer

Following a CBS Evening News story, NBC Nightly News (7/29, story 7, 1:00, Williams) reported, "Now to the news just out...about the tanning bed industry. While the risk of skin cancer is well known, [a] dire warning...compared the effects to cigarette smoking and arsenic." Chief medical editor Nancy Snyderman, MD, explained that according to the World Health Organization, "an exponential increase in...skin cancer" can be linked "to the use of indoor sun and tanning booths." For people who "start using the booths before the age of 30," their "risk goes up 75 percent."

The Tampa Tribune (7/30) reports that "the declaration by" the WHO's International Agency for Research on Cancer (IARC) that "tanning booths emitting ultraviolet radiation are carcinogenic" simply "echoes what dermatologists say they've suspected for years." The declaration, published in the August issue of The Lancet Oncology, ranked tanning beds "right up there with tobacco smoke and mustard gas." Dermatologist Neil Alan Fenske, MD, of the University of South Florida, pointed out that "for some time, tanning beds that use ultraviolet rays were suspected of causing skin cancer." He stated that "the members of the American Academy of Dermatology have been fighting this battle for a number of years," adding that "patients who have received abundant amounts of light via tanning beds have developed extraordinary numbers of skin cancers."

The Detroit Free Press (7/30, Satyanarayana, Warikoo) reports that IARC made its "announcement after finding enough evidence in people and mice that UVA and UVB rays damage skin-cell DNA, sometimes in cancer-blocking genes." The damage may result in "three types of skin cancer: the less dangerous basal and squamous cell skin cancers and melanoma," explained dermatologist Darius Mehregan, MD, of Wayne State University. The Free Press notes that "the American Academy of Dermatology had no comment on the international decree, and calls to the Indoor Tanning Association were not immediately returned."

According to MedPage Today (7/29, Bankhead), "citing evidence from case-control studies and a meta-analysis, the IARC monograph working group 'raised the classification of the use of UV-emitting tanning devices to Group 1, 'carcinogenic to humans.'" In addition, "the working group also cited case-control studies showing 'consistent evidence of an association between the use of UV-emitting tanning devices and ocular melanoma.'" In fact, "the IARC reclassified all forms of ultraviolet radiation as a single carcinogenic entity. Historically, mutations caused by exposure solar radiation had been attributed to UVB," but "the same mutation was identified in UVA-induced skin tumors in mice." In its update, "the IARC moved UV radiation as a whole into the highest-risk category, eliminating distinctions between UVA, UVB, and UVC."

The Philadelphia Inquirer (7/29, Ryst) quoted John Overstreet, executive director of the Indoor Tanning Association, as saying, "Because tanning beds produce the same UV light as the sun, overexposure and abuse of our product -- just like overexposure to sunlight -- is associated with an increased risk for some types of skin cancer." (courtesy AOA)

This is just another example of how harmful UV rays can be to our health. Your eyes should be protected by quality sunglasses.

Surgery for adult strabismus

The Chicago Tribune (7/29, Channick) reports that strabismus "a disease generally associated with children," is now affecting an increasing number of adults. An "imbalance of the ocular muscles, strabismus causes crossed eyes, lazy eye and double vision, conditions that affect about four percent of the population, according to the American Association for Pediatric Ophthalmology and Strabismus." In younger patients, "eye exercises, patches and surgery are often used to prevent visual impairment." In adults, however, "a long-standing medical belief that corrective measures wouldn't work...relegated" many "to years of thick prismatic glasses, which more or less bend the images into rough alignment." Now, "surgery is becoming the preferred method for correcting the problem in adults." It "involves detaching one or more of the six ocular muscles and repositioning them to allow the eyes to work in tandem, creating a unified image. (courtesy AOA)

Diabetes treatment may help cut vision loss

Bloomberg News (7/28, Ferrer) reports that, according to a study published July 27 in the Archives of Internal Medicine, "type 1 diabetics cut their rates of vision loss, kidney damage, and heart disease when they maintained long-term, intensive insulin therapy." In fact, "patients who got three or more insulin shots per day reduced their incidence of eye damage to 21 percent compared with 50 percent of the conventionally treated patients, who got one to two injections daily," while "rates of kidney damage dropped to nine percent from 25 percent with the intensive therapy." To reach these conclusions, researchers from Harvard Medical School followed 1,441 patients from three studies.
"Long-term follow-up of clinical trial participants who got intensive therapy that's now considered standard care revealed that 21 percent developed proliferative retinopathy, nine percent had nephropathy, and nine percent had cardiovascular disease after 30 years with type 1 diabetes," MedPage Today (7/27, Phend) reported. And, "in the same trial, standard therapy circa 1983 yielded long-term complication rates of 50 percent, 25 percent, and 14 percent, respectively." MedPage also noted that "intensive therapy has gotten a bad rap recently in type 2 diabetes in trials such as ACCORD and the VA Diabetes Trial in which treating to a target under the standard seven percent showed no cardiovascular benefit and increased mortality." The study authors pointed out that "the reason for the mortality risk is still under debate, but there's no such concern in type 1 diabetes."

Advances in cataracdt surgery

Pennsylvania's Tribune-Democrat (7/27, Griffith) reports that "a new generation of artificial implanted lenses has" eliminated "the need for glasses after cataract surgery." Recent "advances have introduced multifocal implants and accommodating implants that provide both near and far vision" for patients. The "multifocal lenses have different surfaces for each distance, much like a progressive bifocal in glasses," and "accommodating lenses flex with the eye like the natural lens." Unfortunately, these lenses are "not covered by Medicare or many other insurance policies," resulting in an out-of-pocket cost of "about $2,000 to $3,000" or more to patients. As for the cataract surgery itself, it is "minimally invasive," and "uses an ultrasound device to break up the damaged lens so it can be removed through a tiny incision." The procedure "takes about 10 to 15 minutes and uses only local anesthesia," with "full recovery...expected in a few weeks."

FDA approves ketorolac tromethamine solution to treat pain, inflammation after cataract surgery.

Medscape (7/24, Waknine) reported that the Food and Drug Administration "has approved a 0.45 percent ophthalmic solution of the nonsteroidal anti-inflammatory drug ketorolac tromethamine (Acuvail, Allergan, Inc) for the treatment of pain and inflammation after cataract surgery." According to the agency, "the recommended dose is one drop applied to the effective eye twice daily, starting one day before surgery and continuing through the first two weeks of the postoperative period." The FDA based its approval "on clinical study data derived from more than 500 patients, showing that use of ketorolac solution significantly improved the summed inflammation score and ocular pain relief after cataract extraction and posterior chamber intraocular lens implantation (32 percent vs. 17 percent for vehicle alone)."

Fish oil might be good for AMD

The UK's Daily Mail (7/24, Hope) reports that, according to a study "to appear in the American Journal of Pathology next month," foods "containing omega 3 and fish oils may help prevent" age-related macular degeneration (AMD), "the most common cause of blindness in old age." For the study, researchers at the National Eye Institute "fed mice with high levels of omega 3," and "found those eating more fish oils had lower levels of AMD." In fact, "the condition improved in 57 percent of mice fed the highest levels for at least 12 weeks, compared with just four percent on lower levels of omega 3." While it remains unclear "how omega 3 works," the investigators theorize that "the mechanism may be anti-inflammatory."

The UK's Telegraph (7/23, Smith) reported that prior research conducted by a team from Tufts University "found that a diet rich in omega three, found in mackerel and salmon, can reduce the risk of developing macular degeneration by a third in humans." In the Tufts study, researchers found that "progression of advanced disease was 25 percent less likely in those eating two portions of oily fish a week." (courtesy AOA)

Drug delivering contact lenses.

Wired (7/22, Leggett) reports that, according to a study published in the July issue of Investigative Ophthalmology & Visual Science, Harvard University scientists "report that they've created a contact lens that can deliver a high concentration of antibiotic at a constant rate for more than 30 days." The investigators "describe their new design like a pita pocket, with a big wad of drug in the middle of a hydrogel exterior." In order "to make their lens, the researchers took a biodegradable polymer called PLGA and dissolved it in an organic solvent, and then they added their drug. As the solvent evaporated, they were left with drug mixed into a polymer film." Next, "they coated the film in a hydrogel called pHEMA, which is the same material that's used to make regular contact lenses." In laboratory dish studies, the "prototype lens" has been tested with the antibiotic "ciprofloxacin, which is commonly used to treat eye infections."

Juvenille Arthritics need regualr eye exms

Mississippi's Clarion-Ledger (7/21, Posey) reports that an estimated "300,000 children" are "diagnosed yearly with one of the multiple forms of juvenile idiopathic arthritis." But, "considering parents may dismiss a child's complaints" as growing pains, and "pediatricians may misdiagnose" the problem, "the actual number of cases may be higher." Currently, "juvenile idiopathic arthritis is classified by the number of joints involved. Polyarticular involves five or more joints," while "pauciaticular affects four" joints of fewer, and "systemic onset involves high fevers, a rash and pain in small joints." Treatment of juvenile arthritis "varies for each patient, and often is trial and error," regularly including "drugs to control inflammation, relieve pain, prevent joint damage, and maximize functional abilities. Regular visits to an eye doctor are essential, too."

Protect your eyes.

Utah's Standard-Examiner (7/17, Park) reported that "July is 'UV Awareness Month,' and besides protecting children from sunburns, adults also need to protect the eyes of children from the sun's ultraviolet rays." Optometrist Renny Knowlton, OD, advised parents to exercise "good judgment and common sense." Children who "spend a good deal of time in the sun" need to "protect their eyes with sunglasses coded for UVA and UVB rays, he said. Some children will not wear sunglasses for long, so have them wear a hat with a brim to help shade their eyes." According to Whitney Johnson, health educator with the Utah Cancer Control Program with the state health department, "parents should buy sunglasses with a UV rating," and should consult with "an eye doctor" to find out which sunglasses are best. And, "to protect children's eyes while playing in the water or swimming outside, Johnson said, children should wear sun goggles that also have UV protection ratings." (courtesy AOA

I've been thinking of adding a collection of kid's sunglasses. Are there people out there who are interested in protecting their kid's eyes from the sun as mentioned above? I know my boys love to wear sun glasses. After all they just want to be like Daddy.

Putting the lens in the eye

Following a WebMD story, HealthDay (7/16, Preidt) reported that people with myopia "who can't have laser-assisted eye surgery may benefit from implantable lenses made of a" collagen copolymer, according to a study published in the July issue of the Archives of Ophthalmology. For the study, researchers at Japan's University of Kitasato School of Medicine "evaluated 56 eyes of 34 patients with the implantable lenses," assessing patients "at regular intervals for four years after implantation." They found that "after four years, 44 of the eyes (79 percent) were within 0.5 diopter...of the targeted correction, and 52 eyes (93 percent) were within one diopter." In addition, the investigators observed "no vision-threatening complications during the follow-up period." The authors concluded that "these lens implants 'may be a good alternative for the treatment of moderate to high myopia.'"

Interesting developments in Glaucoma research

In the New York Times (7/15) Times Essentials: Reporter's File, Peter Jaret observed that "a new paradigm for understanding glaucoma has emerged. Glaucoma isn't simply an eye disease, experts now say, but rather a degenerative nerve disorder, not unlike Alzheimer's or Parkinson's disease." While "researchers still recognize high pressure within the eye as a leading risk factor for glaucoma," it is becoming clear that the condition "begins with injury to the optic nerve as it exits the back of the eye. The damage then spreads, moving from one nerve cell to adjoining nerve cells." Neeru Gupta, MD, PhD, of the University of Toronto, explained, "In glaucoma, we've shown that when your retinal ganglion cells are sick, the long axons that project from the eye into the brain are also affected, resulting in changes that we can detect in the vision center of the brain." This "phenomenon, called transynaptic damage, occurs in Alzheimer's and Parkinson's disease, as well." (courtesy AOA)

This research should help us understand and develop new treatments that address the root problems with Glaucoma.

August is National Children's Vision and Learning Month

Florida's Cape Coral Daily Breeze (7/16, Cassidy) reports that "August is National Children's Vision and Learning Month," so "optometrists want to educate parents, teachers and children on the link between vision and learning." According to optometrist Rodney J. Smith, OD, "the American Optometric Association recommends children get their first eye exam at six months, adding that their next checkup should be at about age three, then every year until they begin kindergarten," because "a child's vision needs to be clear to facilitate normal development." Yet, Dr. Smith said that "he rarely sees children brought in for an exam at the recommended ages, even though many of them can develop eye issues that early." The American Optometric Association has estimated that "60 percent of students identified as 'problem learners' have undetected vision problems, meaning that some could see improvement in their school work with a pair of glasses or contact lenses." (courtesy AOA)

Clear View Eye Care has the tools to diagnose and treat many of these vision problems. We would love to see your children. They are fun to have in the office.

Smoking is bad for Multiple Sclerosis

In the Boston Globe (7/13) White Coat Notes blog, Elizabeth Cooney wrote, "Smoking cigarettes is known to raise the risk of developing multiple sclerosis, but medical researchers haven't established whether patients who already have the neurological disease do more damage by continuing to smoke." Now, a team of scientists from Brigham and Women's Hospital, Massachusetts General Hospital, and Harvard University have found that "smoking accelerates the progression of MS from an illness with occasional symptom-free periods to an unrelenting, worsening condition."
That conclusion was drawn "from a study that included 1,465 multiple sclerosis (MS) patients, average age 42, who had had MS for an average of 9.4 years," according to HealthDay (7/13, Preidt). There "were 257 current smokers, 428 past smokers and 780 participants who had never smoked." At baseline, "current smokers had significantly more severe disease and were also more likely to have primary progressive MS (a steady decline in health status), rather than relapsing-remitting MS (alternating periods with and without symptoms)," the team pointed out in the Archives of Neurology. For approximately three years, 891 of the study participants were tracked in an effort to see "how many changed from relapsing-remitting MS to secondary progressive MS, which is a steady decline that develops after a period of relapsing-remitting MS."
The researchers found that the "adjusted hazard ratio for advancing to secondary progressive MS was 2.50 for smokers relative to patients who had never used cigarettes," MedPage Today (7/13, Gever) reported. The UK's Press Association (7/14) also covers the story.

Hyperopic Lasik complications

One thing I have noticed about hyperopic Lasik is that the results are not as predictable as myopic Lasik. I have one patient at Clear View Eye Carewho was a moderate hyperope before Lasik. She was good for about 2 years and then her Rx started to shift. Now she has a new Rx about every two weeks. Orhtokeratology might have been a better option for her.

Protect your eyes from the sun

In a column carried by the Canwest News Service (7/6), optometrist Todd Wilbee, OD, explains "the need for effective protective eyewear from the sun." Dr. Wilbee observes, "All well-made sunglasses on the market have 100 percent UV protection. The benefits of UV protection are well known, including the reduction of skin cancer to the eyelids, the chance of benign growths on the white of the eye, cataract growth, and macular degeneration progression." For people who already wear eyeglasses, "transitions lenses are very popular," and come in "single vision, lined bifocal, or progressive lenses." The lenses "will adjust" their "tint based on the amount of UV light present" and "offer 100 percent UV protection." Polarized sunglasses provide "exceptional glare reduction in bright outdoor lighting." Because "there is a lot to consider when selecting the best type of sunglasses," Dr. Wilbee advises readers to "talk to" their "local optometrist or optician to find the best sunglasses."

Clear View Eye Care carries a selection of sunwear to help protect your eyes from the sun. The selection includes non-prescription for those who wear contacts and sunglasses that are Rx-able. Your second pair is 1/2 off to help with the cost of an additional pair of glasses.

Protect those eyes from UV rays.

The Miami Herald (6/30, Asuaje) reported that, according to Tim Murray, MD, of the University of Miami's Bascom Palmer Eye Institute, "both types of ultraviolet radiation -- UVA and UVB -- can damage various parts of the eye," which "can cause cataracts and an increased risk of macular degeneration." In addition, "extreme UV exposure can also cause growths on and around the eyes, and an increased risk of cancer in the tissues around the eye and the eye itself, he said." To reduce the risk of sun-related eye damage in children and adults, "the American Optometric Association recommends" sunglasses that "absorb at least 99 percent of UV rays, a number verified by the FDA that can be found on the labels attached to sunglasses." And, "for those who spend extended periods of time outdoors," the AOA "recommends wearing wrap-around sunglasses that cover the temple area, as light can enter the eyes from the sides of the face." In fact, optometrist Judi Schaffer, OD, "often recommends polarized sunglasses to her patients because they are the best for blocking out harmful rays."