New treatments for an 'old' eye disease.

SUNDAY, Sept. 27 (HealthDay News) -- Already a leading cause of vision loss among people older than 60, age-related macular degeneration is expected to skyrocket in numbers over the coming decades as the U.S. population grows older.

However, a series of new treatments now under study or in development should mean that eye specialists will be well-prepared to treat the coming surge of macular degeneration cases.

These include refinements of treatments that have proven effective against some forms of the disease as well as new therapies targeting forms of macular degeneration that have so far proven impossible to treat.

Age-related macular degeneration involves the breakdown of the macula, which is located in the retina and helps provide clear central vision. As the macula deteriorates, people see a blurred spot in the center of their vision that grows over time.

Macular degeneration comes in two forms, wet and dry. Current treatments for the wet form of the disease -- in which abnormal new blood vessels in the eye cause leakage and bleeding -- have proven quite successful. The wet form is more rare but can cause rapid vision loss if not caught early.

Researchers have discovered a combination therapy of vitamins and antioxidants that reduces the risk of progressive vision loss by more than 20 percent, said Dr. David W. Parke II, executive vice president and chief executive of the American Academy of Ophthalmology.

Other progress against the wet form of the disease has come through the use of drugs that target vascular endothelial growth factor, or VEGF, a substance in the body that promotes the growth of new blood vessels.

"We now have treatments where, when we catch people early in the course of the disease, the chance of vision loss is less than 10 percent over a two-year period," said George Williams, chairman of ophthalmology and director of the Eye Institute at William Beaumont Hospital in Royal Oak, Mich. Those treatments also provide a 20 to 30 percent chance of significant vision improvement over the same period.

No effective treatments have been found for the dry form of macular degeneration, which causes less catastrophic vision loss but accounts for 85 percent of all macular degeneration cases, according to the U.S. National Eye Institute. The dry form occurs when the light-sensitive cells in the macula begin to slowly break down.

New advances in the treatment of the wet form involve further research into vitamin combinations that can help slow the progress of macular degeneration, Parke said. An ongoing trial is looking into whether diet or supplements can better improve a person's chances of retaining clear vision late in life.

"Around the world, there are culturally different rates of progression," Parke said. "The question becomes, how much of this is dietary?"

Research also has focused on the two drugs currently used to target VEGF, with a head-to-head study now looking into which of the two is more effective. "It's a very important trial, and I think all involved are looking forward to seeing if these drugs have a lot of differences," Parke said.

Other anti-VEGF drugs are in the pipeline, Williams said, and studies are testing ways to combine anti-VEGF medications with radiation or laser therapy to produce better results.

Cutting-edge research also may have found another way to tackle the wet form of macular degeneration. In the June 14 issue of Nature, doctors reported that blocking the activity of a specific protein can reduce the same blood vessel growth that leads to the wet form.

"We now have the opportunity to develop drugs that target this protein that may be safer and more effective than our current treatments," Parke said.

As far as the dry form of macular degeneration, eye experts are exploring ways that drugs used to treat other nerve-damaging diseases such as Alzheimer's might be able to help save people's eyesight, Williams said.

"We're fairly optimistic that within three to five years we'll have a treatment for the dry form of macular degeneration," he said. "We know what happens is the nerve cells that sense the light are dying off. The thought here is if we attack the process that makes them die, we can save the vision."

Eat your vegetables and wear sunglasses.

(Healthday News) -- If you're planning to retire to Florida or Arizona for health reasons, be sure to pack your sunglasses.

That's the message from a new study that found that older people with low levels of certain antioxidants present in many fruits and vegetables, and who are exposed to short-wavelength blue light from the sun, are more likely to develop certain types of age-related macular degeneration (AMD). But the damage can start decades before you turn 65.

"We recommend that people use eye protection, including sunglasses and wide-brimmed hats, if going outside and especially in bright sunlight" and during the middle period of the day, said Astrid E. Fletcher, lead author of the study published in the October issue of the Archives of Ophthalmology.

"Our advice on nutrition," she added, "is that people should ensure that they follow the five-a-day recommendations. In particular, they should see that their diet includes leafy green vegetables, citrus fruit, vegetable oils and nuts, as these are good sources of the antioxidant vitamins of relevance to the retina."

Dr. Julie Belkin, an ophthalmologist with University Hospitals Case Medical Center in Cleveland, said, "Sunglasses are recommended anyway, and most people who have a normal, balanced diet will get adequate levels of those antioxidants. But there are vitamin supplements if you have other risk factors or other eye findings that put you at risk."

While the authors of the new study found that the link between blue-light exposure and low antioxidant levels was stronger in middle age, compared to younger years, other experts said it's unclear when the damage takes place.

"We don't really know how many years it takes" for AMD to develop. "For some people, it could be a few years in the sun is bad, and for others, a few decades is bad," said Dr. Robert Cykiert, an associate professor of ophthalmology at New York University Langone Medical Center in New York City.

Previous studies had suggested that blue light may damage the retina and set eyes on the path to developing AMD, a leading cause of vision loss in Americans aged 60 and older.

Studies have also shown that antioxidant enzymes such as vitamins C and E, the carotenoids (lutein and zeaxanthin), and zinc can protect against blue light. But no one had really looked at how blue light and antioxidants might interact to affect the risk for AMD.

After studying nearly 4,500 older Europeans (average age 73.2 years), the study authors, from the London School of Hygiene & Tropical Medicine, found no overall association between blue-light exposure and neovascular (early) AMD.

However, blue light exposure was associated with neovascular AMD in 25 percent of the people with the lowest antioxidant levels.

"This is the first time they've looked at this in so many patients, but it makes sense from a physiological standpoint," said Dr. David M. Kleinman, an assistant professor of ophthalmology at the University of Rochester Eye Institute. "In addition to there being some things we can't control, like genetic predisposition, really taking care of ourselves in a certain way will really help reduce vision loss from AMD."

That includes exercising and controlling blood pressure and cholesterol, added Kleinman, a retina specialist who studies macular degeneration.

A second study in the same issue of the journal found that, overall, visual impairment is more common in people with diabetes than in those without the disease.

The news is especially worrisome given the veritable epidemic of diabetes: In 2005, an estimated 14.6 million Americans had been diagnosed with diabetes, on top of 6.2 million undiagnosed individuals. The number of people with diagnosed diabetes in the United States is expected to reach almost 50 million by 2050.

Diabetic retinopathy is one of the most common complications of diabetes, but other eye problems can occur as well, including cataracts and glaucoma, according to the study by researchers at the U.S. Centers for Disease Control and Prevention.

Some 11 percent of U.S. adults with diabetes have some form of visual impairment, 3.8 percent uncorrectable and 7.2 percent correctable. Almost 6 percent of those without diabetes have some form of visual impairment, 1.4 percent uncorrectable and 4.5 percent correctable, the study found.

Eyelids are a common place for skin cancer

California's San Gabriel Valley Tribune (9/18, Jansen) reports that the eyelid "is one of the most common sites for skin cancer, accounting for as much as 10 percent of all skin cancers. Left untreated," cancers there "could lead to significant injury and even blindness." The Skin Cancer Foundation explained that "with their delicate structure and greater exposure to the sun, the eyes and surrounding areas are particularly prone to cancers," and people who have "fair skin, light eyes," or "who are older have an increased risk of skin cancer and eye diseases." The "most common" form of cancer of the eyelid is "basal cell carcinoma." To prevent eyelid cancer, people should wear sunscreen, wear wide-brimmed hats, and "wear sunglasses with 99-100 percent UV protection year-round."

Tooth surgery restores sight.

USA Today (9/17, Marcus) reports that on Wednesday, physicians from the Bascom Palmer Eye Institute at the University of Miami Miller School of Medicine announced that "they had performed a vision-restoring surgery that used" a "60-year-old patient's tooth" to restore her sight. Over the Labor Day weekend, physicians there performed surgery that allowed Sharron Thornton "to see for the first time in nine years." Following the surgery, Thornton "was able to see 20/60" instead of "only shadows," surgeon Victor Perez, MD, explained.
The Miami Herald (9/17, Tasker) reports that during the operation, "surgeons removed one of" Thornton's "teeth, drilled a hole in it, inserted a plastic lens into the hole, and implanted the tooth-lens combination into her eye." As a result of this procedure, "the first such operation in the United States," Thornton can now "recognize faces and read a newspaper with a magnifying glass." Her physicians say "she should get better vision once she is fully healed and fitted with glasses."
"The tooth and the lens were implanted under the patient's skin in the cheek or shoulder for two months so they could bond, then they were carefully implanted in the center of the eye after a series of procedures to prepare the socket," the AFP (9/17) reports. A statement from the Bascom Palmer Eye Institute explained, "A hole is made in the mucosa for the prosthetic lens, which protrudes slightly from the eye and enables light to re-enter the eye allowing the patient to see once again."

Triamcinolone may restore vision

HealthDay (9/15, Dotinga) reported that, according to a study published in the Sept. issue of the journal Ophthalmology, researchers from the University of Wisconsin-Madison said "they've found the first long-term treatment for people who suffer vision loss when the large veins in their eyes become blocked." The group discovered that "injections into the eye of a corticosteroid" called triamcinolone "improved vision in patients."
Reuters (9/15, Stern) reports that central retinal vein occlusion is a common complication of diabetes, occurring when blood clots hamper or impede circulation in retinal tissue. Following age-related macular degeneration, it is the second most common cause of vision loss.
CQ HealthBeat (9/16, Reichard) reports, "After one year, treated patients were five times more likely to be able to experience a vision gain of three or more lines on a vision chart," which is "the equivalent of reading letters half as small as before treatment."

Have you had your eyes checked lately?

SATURDAY, June 6 (HealthDay News) -- Though good vision is what allows the perception of the colors, shapes and sights of the world, Americans appear to be fairly lackadaisical when it comes to protecting their eye health, according to surveys done by U.S. eye groups.

People who wear eyeglasses or contact lenses constitute 81 percent of the population, according to a survey done by the American Optometric Association.

But one of every five of them hasn't seen an eye doctor or eye-care specialist in more than two years, the recommended period between eye checkups, the survey found.

It's even worse for people who don't use corrective lenses. Of that group, three of every five haven't had a vision exam in more than two years.

Doctors believe this is because most vision problems aren't readily apparent and because people have enough on their plates without also having to schedule an eye exam.

"We're getting pulled every which way these days," said Dr. Andrew Iwach, an associate clinical professor of ophthalmology at the University of California, San Francisco, and a spokesman for the American Academy of Ophthalmology. "We're busy. For most of us, our vision is probably pretty good, we're getting along fine, and so we don't worry about it. And that comfort may lead to complacency."

A survey by the academy seems to support that belief. Only 28 percent of people surveyed felt they were at risk for any sort of eye disease, and just 23 percent said they were very concerned about losing their vision.

The problem with these perceptions is that most eye diseases come on subtly. Once someone recognizes vision loss, it's usually too late to have pursued many avenues of treatment, said Dr. Kerry Beebe, an optometrist in Brainerd, Minn., and a spokesman for the American Optometric Association.

"What we hear most of the time is, 'I'm not having any problems. My eyes don't hurt, and I think I see pretty good,' " Beebe said. "They don't realize a lot of eye diseases don't have any symptoms in the early stages, which is where you'd like to treat those kinds of problems."

For example, vision loss for people with glaucoma occurs at the edges of the visual field, Iwach said.

"By the time you realize something is wrong, a lot of vision loss has occurred," he said. "But if we catch it earlier, there's a lot we can do."

And, he says, eye doctors and eye-care specialists also might be able to catch other things that are wrong simply by peering into and testing someone's eyes.

"The eye is very unique," Iwach said. "It's the only place in the body we can see a bare vein, artery and nerve. We can actually see the back of the eye and the optic nerve. This can give us clues and tips that there might be other systemic diseases going on."

For example, some problems of the eye can serve as early warning signs of diabetes, he said.

The American Optometric Association recommends that adults get their vision checked at least every two years, even if they don't perceive any problem with their sight. Children should have their vision tested at 6 months of age, 3 years old and right before they enter first grade and then every two years thereafter.

The association's survey found that eight of 10 kids aren't getting that first vision test by age 1. "Parents figure they must see fine, they aren't complaining, and I don't see a problem," Beebe said. "But kids have no base to compare what they're supposed to be seeing. They can't tell something's wrong."

You also should see an ophthalmologist at least once by age 40, according to new guidelines set by the American Academy of Ophthalmology. Ophthalmologists are medical doctors who have specialized in eyesight and are the best-trained of all eye-care providers. "It puts us in an ideal position to make assessments of risk," Iwach said.

Having had that baseline examination by 40, an ophthalmologist is then in a good position to track a person's sight as age-related problems such as cataracts or macular degeneration threaten sight.

"We so rely on our eyes," Iwach said. "We so enjoy our vision and what it brings to us. It doesn't require much maintenance, but if we don't provide at least a minimum amount of scheduled maintenance, it can lead to later vision loss."

New drug for itchy eyes approved.

The AP (9/9) reported that on Sept. 8, "the Food and Drug Administration approved" Ista Pharmaceuticals, Inc.'s "treatment for itchy eyes in patients with allergic conjunctivitis." Called Bepreve [bepotastine besilate ophthalmic solution], the "eye drops are approved for use by patients" two years of age and older.
According to the Dow Jones Newswire (9/10, Cummings), "Ista said Bepreve and its anti-inflammatory eye drug Xibrom [bromfenac ophthalmic] will share the top spot in the company's promotional activities." Reuters (9/9) and the Orange County Business Journal (9/9, Reed) also covered the story.

Choose wisely when buying sunglasses

SUNDAY, June 21 ()HealthDay News) -- Price and style -- not protection from the sun's harmful rays -- are most people's main considerations when buying sunglasses, a new survey has found.

But that's not a good thing, health-wise, says the American Optometric Association, which conducted the survey.

"Overexposure to UV [ultraviolet] rays has been linked to a variety of problems, including age-related cataracts and degeneration of the cornea," Dr. Gregory W. Good, an optometrist and association spokesman, said in a news release from the group. "Other disorders that can occur are abnormal growths on the eye's surface and even sunburn of the eyes. These conditions can cause blurred vision, irritation, redness, tearing, temporary vision loss and, in some instances, blindness."

He recommends that people wear quality sunglasses that offer proper UV protection and a wide-brimmed hat whenever they're outside. Some contact lenses, Good noted, contain a UV blocker that helps protect the eyes.

To prevent UV-related eye damage, the association recommends that people:

* Wear UV-protective eyewear even on cloudy days and in the winter.
* Select quality sunglasses or contact lenses that block out 99 to 100 percent of UV-A and UV-B radiation and screen out 75 to 90 percent of visible light.
* Make sure that sunglass lenses are perfectly matched in color and free of distortions or imperfections.
* Select gray-colored lenses because they reduce light intensity without altering the color of objects, which means they provide the most natural color vision.
* Get regular eye exams to monitor eye health, maintain good vision and keep up-to-date on the latest in UV protection.

It's also especially important, the association said, for young children and teens to have UV-protective eyewear because they typically spend more time in the sun than adults, putting them at greater risk for eye damage.

Eye implant helps patients with retinitis pigmentosa to see.

The Philadelphia Inquirer (9/8, Avril) reports that two months ago, surgeons at the Wills Eye Institute "implanted a small array of electrodes in the back of" Michael "Adler's left eye." Now, "in the last few weeks -- with the aid of a small video camera in his sunglasses that transmits images to his retinal implant -- he has begun to gain some limited vision." To date, "surgeons have implanted the devices in the retinas of 32 people around the world. All have a severe form of retinitis pigmentosa, an inherited disease that causes retinal degeneration." The "retinal implant bypasses damaged cells in the eye, transmitting signals to the same part of the brain that registers images in people with normal vision." While "the resulting black-and-white images are very low-resolution, consisting of just 60 pixels," they do allow Adler to "see the outlines of doors and sidewalks, and he can pick out plates on the dinner table."

Eye exams for children are important

Wisconsin's Appleton Post-Crescent (9/7, Dums) reported, "Children often cannot communicate they are having vision problems because they do not realize they are having them." Screenings "at a pediatrician's office or at school" often "miss problems that kids are having that they can't verbalize," said Carin LaCount, OD, who explained that uncorrected vision problems may even "hamper learning." She recommended that "children get their eyes examined by an optometrist." Dan Nowak, OD, pointed out that as children's "bodies change, their eyes change." Annette Wilde, OD, noted that "eye exams can begin as early as six months and can be free, if done by eye doctors participating in the public health program InfantSee." After that "early exam, children's eyes should be checked at three years of age, kindergarten, and then every year," Dr. Wilde said. In particular, children who have "a family history of vision problems" need to see an optometrist. (courtesy AOA)

Dry eyes become more prevalent after age 50.

FRIDAY, June 12 (HealthDay News) -- Here's more bad news for men turning 50: After their half-century mark, about 4 percent of males develop dry eye disease, making it one of the most common eye conditions and reasons for seeing an eye doctor in the United States, researchers say.

Dry eye disease causes a persistent dryness, itching or burning sensation in the eyes, according to the North American Neuro-Ophthalmology Society. Some people with dry eye disease also say that it feels like they have sand or grit in their eye.

While research has shown the condition is more common among women, about 1.68 million men over age 50 in the United States have it, Debra A. Schaumberg of Brigham and Women's Hospital in Boston and colleagues noted in the June issue of the Archives of Ophthalmology.

Among men, increasing age, high blood pressure, benign prostatic hyperplasia (a noncancerous enlargement of the prostate) and the use of antidepressants increase the chances of developing dry eye disease, the study authors explained.

"It is an important public health problem, causing increased risk of ocular infections and bothersome symptoms of ocular discomfort, fatigue and visual disturbance that interfere with crucial activities, such as reading, working on a computer and driving a car," Schaumberg and colleagues wrote.

In the study, the researchers analyzed data on 25,444 men who participated in the Physicians' Health Study I and II, landmark studies begun in 1982. The men were asked if they had ever been diagnosed with dry eye disease and also whether they had symptoms, including dry or irritated eyes.

About 3 percent reported a previous diagnosis of dry eye, while 6.8 percent said they had constantly or often experienced at least one symptom such as dryness or irritation. About 2.2 percent reported both symptoms constantly or often, the study found.

The prevalence increased with age, and while the researchers estimated about 3.9 percent of men between 50 and 54 have dry eye, at age 80 or beyond, about 7.7 percent of men have dry eye. The total age-standardized prevalence among men aged 50 and older was 4.34 percent, according to the study.

As the baby-boomer generation ages, the authors said they expect to see more cases of dry eye.

"These data, derived from studying more than 25,000 men, show a significantly lower prevalence of dry eye disease than was found in a similar study using the same methods in U.S. women, among whom the prevalence was estimated at 3.23 million women," Schaumberg's team wrote. "Nonetheless, there is a significant increase in the prevalence of dry eye disease with age among men, as is the case among women, and there is a predicted growth to 2.79 million U.S. men affected by dry eye disease in 2030."

Aside from discomfort, dry eye can also cause blurry or double vision.

Some people get relief by drinking more water to relieve mild dehydration, switching medications, discontinuing wearing contact lenses or by using artificial tears sold over-the-counter at drugstores.

Physicians may also prescribe anti-inflammatory eye drops for patients with severe dry eyes.

Old makeup is risk for eye infections.

The UK's Daily Mail (9/4) reports that a recent survey by Mintel revealed that three out of four women may be "putting their health at risk by using old cosmetics for several years, even if they begin to smell or" change color. According to "beauty analyst" Alexandra Richmond, "like food, cosmetics can expire and become dangerous to use." Since 2005, the EU has required that "all cosmetics that could deteriorate after opening" must "carry advice on when they will expire." In the UK, consumers "can simply look" for the "Period After Opening" symbol on packaging to determine "how many months the product will last." Many women "ignore this," however, and "continue to use mascaras and eye pencils after their six-month lifespan." Pointing out the dangers of this practice, Dr. Chris Flower, of the UK's Cosmetic, Toiletry and Perfumery Association, said that "eye-area cosmetics can become infected and cause problems for the eyes." (courtesy AOA)

When your kids need glasses

(HealthDay News) -- Some children may resist wearing eyeglasses, despite the resulting improvement in vision, school work and even extracurricular sports.

The Cleveland Clinic offers these suggestions to help your child accept a new pair of glasses:

• Choose frames that fit well, and don't pinch, slip or feel too heavy.
• Ensure that your child's lenses are the right prescription.
• Encourage your child to wear the new glasses a little bit at a time, gradually wearing them for longer periods.
• Ultimately, make putting on and taking off glasses a part of your child's daily morning and bedtime routines.
• Encourage your child with praise every time he or she is wearing the glasses.

-- Diana Kohnle

Cool device may offer 'vision' to the blind

The UK's Daily Mail (9/2) reports that the BrainPort vision device, developed by scientists at Wicab, may help the blind to see by "using their tongue." The device consists "of an inch-long video camera hidden in a pair of sunglasses, which the user wears. Signals from the camera are sent along a cable to a handheld control unit, about the size of a mobile phone, and then to a lollipop shaped stick, which is placed on the tongue." Next, "the control unit converts the image into a low resolution black, white and grey picture, which is then recreated as a square grid of 400 electrodes -- around the size of a postage stamp -- on the lollipop." Even though "users initially 'feel' the image on their tongue, with practice the signals activate the 'visual' parts of the brain for some people." The Daily Mail notes that BrainPort "could be approved for sale" in the US "by the end of the year." (courtesy AOA)

Back to school vision exams for kids.

MONDAY, Aug. 31 (HealthDay News) -- Parents should add an eye exam to their children's back-to-school list, experts say.

Studies show that 86 percent of children start school without ever having an eye examination, even though youngsters can't learn if they can't see properly.

According to the American Optometric Association's 2009 survey, which assesses the knowledge and understanding of issues related to eye and visual health, 88 percent of respondents were unaware that one in four students has a visual impairment.

"Because a child's vision may change frequently, regular eye and vision care is crucial to a student's classroom success," said Dr. Michael Earley, optometrist and the AOA's vision and learning specialist, in an association news release. "Unfortunately, most parents are not including eye exams as part of their child's back-to-school health check-up."

According to the survey, 58 percent of parents did not take their child for an eye exam before age 3. The AOA recommends that the first eye assessment takes place at 6 months of age, followed by comprehensive eye exams starting at age 3, and then repeat exams every two years, unless directed otherwise by an optometrist.

Previous studies have found that 60 percent of children labeled as "problem learners" may actually have undetected vision problems and are sometimes incorrectly diagnosed as having attention-deficit disorder or attention-deficit/hyperactivity disorder, the association noted.

Treatment is more likely to be successful if vision problems are detected and treated early, according to the news release.

In between visits to the eye doctor, parents and teachers should watch for signs of eye problems. Schedule an eye exam if you notice that your child:

* Loses their place while reading
* Avoids close work
* Has a tendency to rub their eyes
* Complains of frequent headaches
* Turns or tilts their head when looking at something
* Makes frequent reversals when reading or writing
* Uses a finger to keep their place when reading
* Confuses or omits simple words when reading
* Seems to consistently perform below potential
* Struggles to finish their homework
* Squints while reading or watching television
* Experiences behavioral problems
* Holds reading material too close to their face

Good vision is crucial to your child's success.

HealthDay (8/31, Thompson) reported that, "according to the American Optometric Association's 2009 survey, which assesses the knowledge and understanding of issues related to eye and visual health, 88 percent of respondents were unaware that one in four students has a visual impairment." In fact, "studies show that 86 percent of children start school without ever having an eye examination, even though youngsters can't learn if they can't see properly." In a news release, Michael Earley, OD, "the AOA's vision and learning specialist," explained, "Because a child's vision may change frequently, regular eye and vision care is crucial to a student's classroom success." The AOA noted that "60 percent of children labeled as 'problem learners' may actually have undetected vision problems and are sometimes incorrectly diagnosed as having attention-deficit disorder or attention-deficit/hyperactivity disorder." (courtesy AOA)

Clear View Eye Care is fully equipped to help your child with their vision exam and treatment. We have numerous kid frames, vision therapy equipment and friendly staff who are prepared to make your child comfortable at our office. We recommend your child's first exam within the first year of life. Call us today.