Month: February 2013

Surgeons from UC Davis Medical Center have demonstrated that artificial muscles can restore the ability of patients with facial paralysis to blink, a development that could benefit the thousands of people each year who no longer are able to close their eyelids due to combat-related injuries, stroke, nerve injury or facial surgery.

In addition, the technique, which uses a combination of electrode leads and silicon polymers, could be used to develop synthetic muscles to control other parts of the body. The new procedure is described in an article in the January-February issue of the Archives of Facial Plastic Surgery.

“This is the first-wave use of artificial muscle in any biological system,” said Travis Tollefson, a facial plastic surgeon in the UC Davis Department of Otolaryngology – Head and Neck Surgery. “But there are many ideas and concepts where this technology may play a role.”

In their study, Tollefson and his colleagues were seeking to develop the protocol and device design for human implantation of electroactive polymer artificial muscle (EPAM) to reproducibly create a long-lasting eyelid blink that will protect the eye and improve facial appearance. EPAM is an emerging technology that has the potential for use in rehabilitating facial movement in patients with paralysis. Electroactive polymers act like human muscles by expanding and contracting, based on variable voltage input levels.

For people with other types of paralysis, the use of artificial muscles could someday mean regaining the ability to smile or control the bladder. Reanimating faces is a natural first step in developing synthetic muscles to control other parts of the body, said UC Davis otolaryngologist Craig Senders.

“Facial muscles require relatively low forces, much less than required to move the fingers or flex an arm,” said Senders.

Blinking is an essential part of maintaining a healthy eye. The lid wipes the surface of the eye clean and spreads tears across the cornea. Without this lubrication, the eye is soon at risk of developing corneal ulcers that eventually can cause blindness.

Involuntary eye blinking is controlled by a cranial nerve. In most patients with permanent eyelid paralysis, this nerve has been injured due to an accident, stroke, or surgery to remove a facial tumor. Many have no other functioning nerves nearby that can be rerouted to close the eyelid. Others were born with Mobius syndrome, characterized by underdeveloped facial nerves. These patients are expressionless and can neither blink nor smile.

Eyelid paralysis currently is treated by one of two approaches. One is to transfer a muscle from the leg into face. However, this option requires six to10 hours of surgery, creates a second wound, and is not always suitable for elderly or medically fragile patients.

The other treatment involves suturing a small gold weight inside the eyelid. The weight closes the eye with the help of gravity. Though successful in more than 90 percent of patients, the resulting eye blink is slower than normal and cannot be synchronized with the opposite eye. Some patients also have difficulty keeping the weighted lid closed when lying down to sleep. In the United States, an estimated 3,000 to 5,000 patients undergo this surgery every year and therefore might benefit from an alternative treatment.

For their study, Senders and Tollefson used a novel alternative method for eyelid rehabilitation in permanent facial paralysis. They used an eyelid sling mechanism to create an eyelid blink when actuated by an artificial muscle. Using cadavers, the surgeons inserted a sling made of muscle fascia or implantable fabric around the eye. Small titanium screws secured the eyelid sling to the small bones of the eye. The sling was attached to a battery-operated artificial muscle. The artificial muscle device and battery were into a natural hollow or fossa at the temple to disguise its presence.

Senders and Tollefson found that the force and stroke required to close the eyelid with the sling were well within the attainable range of the artificial muscle. This capability may allow the creation of a realistic and functional eyelid blink that is symmetric and synchronous with the normal, functioning blink. A similar system also could give children born with facial paralysis a smile.

The three-layered artificial muscle was developed by engineers at SRI International of Palo Alto, Calif., in the 1990s. Inside is a piece of soft acrylic or silicon layered with carbon grease. When a current is applied, electrostatic attractions causes the outer layers to pull together and squash the soft center. This motion expands the artificial muscle. The muscle contracts when the charge is removed and flattens the shape of the sling, blinking the eye. When the charge is reactivated, the muscle relaxes and the soft center reverts back to its original shape.

“The amount of force and movement the artificial muscle generates is very similar to natural muscle,” Tollefson said. An implanted battery source similar to those used in cochlear implants would power the artificial muscle.

For patients who have one functioning eyelid, a sensor wire threaded over the normal eyelid could detect the natural blink impulse and fire the artificial muscle at the same time. Among patients lacking control of either eyelid, an electronic pacemaker similar to those used to regulate heartbeats could blink the eye at a steady rate, and be deactivated by a magnetic switch.

The researchers are now refining the technique on cadavers and animal models. They estimate the technology will be available for patients within the next five years.

The study was funded by a grant from the American Academy of Facial Plastic and Reconstructive Surgery.

Source: David Ong

University of California – Davis – Health System

New research suggests that an eyedrop used to diagnose a rare syndrome in infants can cause severe lethargy lasting up to 10 hours and requiring hospital admission and oxygen administration. In the article “Adverse Effects of Apraclonidine Used in the Diagnosis of Horner Syndrome in Infants.” published in the June issue of Journal of AAPOS (Journal of the American Association for Pediatric Ophthalmology and Strabismus), Dr. Patrick Watts and coauthors described five cases of extreme drowsiness or unresponsiveness after infants under 6 months of age were administered 1% apraclonidine eyedrops.

Apraclonidine was developed to lower intraocular pressure and minimize the systemic side effects associated with the use of its parent drug, clonidine. An investigation of the site of action of apraclonidine incidentally uncovered a reversal of anisocoria in patients with Horner syndrome, a neurologic condition that causes a small pupil and a drooping eyelid on one side of the face. David G. Hunter, MD, PhD, Editor-in-Chief of Journal of AAPOS explains, “Horner syndrome is very rare in infants, but testing occurs frequently, so it is very important that ophthalmologists and neurologists are made aware of this complication.”

Whereas no deaths or permanent injuries occurred, the authors recommended against using apraclonidine in infants. If apraclonidine must be used in infants younger than 6 months of age, the patient should be observed for a period of at least 2 hours after instillation of the drops, with admission to a pediatric ward prompted by lethargy, bradycardia, or a reduced respiratory rate. No problems were reported with use of the medication in older children or adults.

The article appears in Journal of AAPOS (Volume 11, Number 3, 2007), published by Elsevier on behalf of the American Association for Pediatric Ophthalmology and Strabismus.

About Journal of AAPOS

Journal of AAPOS presents expert information on children’s eye diseases and on strabismus as it impacts all age groups. Major articles by leading experts in the field cover clinical and investigative studies, treatments, case reports, surgical techniques, descriptions of instrumentation, current concept reviews, and new diagnostic techniques. The Journal is the official publication of the American Association for Pediatric Ophthalmology and Strabismus.

About Elsevier

Elsevier is a world-leading publisher of scientific, technical and medical information products and services. Working in partnership with the global science and health communities, Elsevier’s 7,000 employees in over 70 offices worldwide publish more than 2,000 journals and 1,900 new books per year, in addition to offering a suite of innovative electronic products, such as ScienceDirect (sciencedirect/), MD Consult (mdconsult/), Scopus (info.scopus/), bibliographic databases, and online reference works.

Elsevier (elsevier/) is a global business headquartered in Amsterdam, The Netherlands and has offices worldwide. Elsevier is part of Reed Elsevier Group plc (reedelsevier/), a world-leading publisher and information provider. Operating in the science and medical, legal, education and business-to-business sectors, Reed Elsevier provides high-quality and flexible information solutions to users, with increasing emphasis on the Internet as a means of delivery. Reed Elsevier’s ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).

Source: Jayne Dawkins

Elsevier

Alimera Sciences, Inc., a privately held biopharmaceutical company that specializes in the research, development and commercialization of prescription ophthalmic pharmaceuticals, reported the interim 12-month safety and efficacy results from the first human pharmacokinetic study (PK Study) of Iluvien(TM). Iluvien is an intravitreal insert being developed for the treatment of diabetic macular edema (DME).

This 36-month, open-label, Phase 2 study, running concurrently with the pivotal Phase 3 FAME(TM) Study (Fluocinolone Acetonide in Diabetic Macular Edema), is designed primarily to assess systemic exposure of the corticosteroid, fluocinolone acetonide (FA), after administration of Iluvien in patients with DME. Secondarily, the PK Study is designed to provide information on the safety and efficacy of Iluvien in a DME patient population. A total of 37 subjects were enrolled in the PK Study, 20 patients on the low dose of Iluvien (an approximate 0.23 micrograms per day dose), and 17 patients on the high dose of Iluvien (an approximate 0.45 micrograms per day dose).

In the 12-month interim readout, no adverse events related to intraocular pressure (IOP) were seen in low dose patients, and 23.5 percent of the high dose patients experienced IOP increases of 30 millimeters of mercury (mmHg) or greater at some time point. By way of comparison, in published results from clinical studies of DME patients using sustained release intravitreal FA in Bausch & Lomb Incorporated’s product Retisert(R), a surgically implanted intravitreal drug delivery device containing 0.59 mg FA approved for the treatment of chronic non-infectious posterior uveitis, 35 percent of the patients experienced IOP increases of 30 mmHg or greater at some time point during the first year.

“This profile of IOP changes occurring only in the high dose group is consistent with the IOP change profiles that were seen at the three and six month readouts,” said Ken Green, Ph.D., Chief Scientific Officer of Alimera Sciences. “Given the lower incidence of IOP changes of 30 mmHg or greater observed with Iluvien, as compared to published clinical data on Retisert, Iluvien may offer an important safety advantage in the delivery of FA.”

From an efficacy perspective, data from the subgroup of patients that reflect the same visual acuity inclusion criteria as that of the larger Phase 3 FAME trial being conducted by Alimera, revealed that 27.3 percent of the high dose patients had an improvement in best corrected visual acuity (BCVA) of 15 letters or greater over baseline and 23.1 percent of the low dose patients had an improvement in BCVA of 15 letters or greater over baseline.

“We are pleased by the strong 15-letter results in both doses as subject follow up continues,” said Dan Myers, President and Chief Executive Officer of Alimera Sciences. In the Retisert DME trials, visual acuity continued to improve over the second year, giving us great encouragement for future interim looks at the Iluvien data. Overall, the results in this small study continue to be in line with our expectations regarding the safety and efficacy of Iluvien.”

Data from the PK Study will continue to be evaluated with interim looks at months 18, 24, 30 and 36. Except for the month 18 and final month 36 looks, when the database will be fully locked, interim evaluations will be based on unaudited data. The last patient was enrolled in this study at the end of February 2008.

About Iluvien(TM)

Iluvien is an intravitreal insert being developed for the treatment of DME. DME is a disease of the retina, which affects individuals with diabetes and can lead to severe vision loss and blindness. Each Iluvien insert is designed to provide a sustained therapeutic effect, up to 36 months for the low dose and up to 24 months for the high dose. Iluvien is inserted into the patient’s eye with a 25-gauge needle, which allows for a self-sealing wound. This insertion is very similar to an intravitreal injection, a procedure commonly employed by retinal specialists.

About Alimera Sciences, Inc.

Alimera Sciences is a biopharmaceutical company that specializes in the research, development and commercialization of prescription ophthalmic pharmaceuticals. Presently the company is focused on diseases affecting the back of the eye, or retina. Its most advanced product candidate is Iluvien(TM), which is being developed for the treatment of diabetic macular edema, or DME. DME is a disease of the retina, which affects individuals with diabetes and can lead to severe vision loss and blindness. Under one protocol, enrollment was completed in October 2007 in two Phase 3 pivotal trials for the use of Iluvien in the treatment of DME conducted across the U.S., Canada, Europe and India, with a combined total enrollment of 956 patients.

Alimera also has entered into an exclusive worldwide agreement with Emory University to explore oxidative stress management — specifically the reduction of reactive oxygen species (ROS) — as a treatment strategy for ophthalmic diseases. Under this agreement, Alimera has acquired options to exclusive, worldwide licenses for two classes of nicotinamide adenine dinucleotide phosphate reduced form (NADPH) oxidase inhibitors, which Alimera is studying as potential treatments for conditions such as the dry form of age-related macular degeneration (AMD), particularly the late stage of this condition known as geographic atrophy. Alimera has exercised its option to acquire a license with respect to one of these classes of NADPH oxidase inhibitors.

Alimera Sciences, Inc.
alimerasciences

“Eyes on the future” is the mantra of the ‘World Sight Day’ held this month to raise awareness of blindness and vision impairment. New technologies, developed by European researchers offering the visually impaired greater independence, live up to this vision.

Many of the most innovative systems have been created by a consortium of companies and research institutes working in the EU-funded ENABLED project.

The project has led to 17 prototype devices and software platforms being developed to help the visually impaired, two of which have been patented.

Guide dogs, canes, Braille and screen readers that turn digital text into spoken audio all help to improve the lives of the blind or severely visually impaired, but none of these tools can make up for having a friend or relative accompany a blind person around and assist them in their daily life. However, a human helper is not always available.

“Blind people often have to rely on others to do things that we do naturally??� and that restricts their independence,” explains Wai Yu, the project’s coordinator and a researcher at the Virtual Engineering Centre at Queen’s University in Belfast.

Activities that the sighted take for granted, such as going for a walk in the park or trying out a new restaurant, becomes an odyssey for the visually impaired, particularly when they do not already know the route by heart.

A guide dog can help them avoid dangers in the street, be it a curb or a lamppost, but it cannot show them a new route. People can be asked for directions, but following them is another matter entirely when you cannot read street signs or see landmarks.

Bridging the information gap

Those barriers have typically prevented the visually impaired from exploring the world around them on their own, but now, with the new technologies, they can surmount some of these barriers.

“Our goal was to give blind people more independence by helping to bridge the information gap with the sighted,” Yu says.

To achieve that, the project partners worked in two broad areas. On the one hand, they developed software applications with tactile, haptic and audio feedback devices to help visually impaired people feel and hear digital maps of where they want to go. On the other hand, they created new haptic and tactile devices to guide them when they are out in the street.

Maps you can feel

One of the patented prototypes, called VITAL, allows users to access a tactile map of an area. Using a device akin to a computer mouse they can move a cursor around the map and small pins will create shapes under the palm of their hand.

The device could produce the sensation of a square block to define a building, or form into different icons to depict different shops and services – an ‘H’ for a hospital, for example.

“Braille readers and audio readers let blind people read or hear text from computers and the internet, but until now there has been no easy or practical way to portray graphical information,” Yu says. “We chose to work with maps because they are particularly useful for visually impaired people.”

Having obtained a ‘mental image’ of the map from the computer, users can then take the route information with them when they venture outside. For that purpose, the project partners used a commercially available navigation aid called the Trekker, which uses GPS to guide users as they walk around, much like a navigation system in a car.

An electronic guide

However, the Trekker gives only spoken directions, something that can be disconcerting for blind people, who may not want to draw attention to themselves. The device can often be hard to hear in noisy, city environments.

The ENABLED team therefore developed prototypes to provide directions through tactile and haptic feedback, rather than via audio alone.

One patented device developed by the project team, the VIFLEX, looks similar to a TV remote control with a movable plate at the front. The user rests his thumb on the plate, which tilts in eight directions to guide users based on the directions given by the Trekker.

“It is more discreet and natural than following audio commands,” Yu says.

The aim of the ENABLED team’s research is not to replace tried and tested aids for the blind, such as canes and guide dogs, but to complement them with new technologies that can improve the independence and autonomy of the visually impaired.

For the visually impaired worldwide, such technologies should start to become a reality over the coming years as the applications developed by the ENABLED team make their way into commercial products.

Source
cordis.europa.eu/ictresults

New evidence that the brain regions responsible for vision are capable of adapting in adults offers new hope for those with an untreated condition commonly known as lazy eye. Also called amblyopia, the condition is the most prevalent cause of visual impairment in a single eye, affecting about six million people in the United States alone.

” If not detected early enough – before seven to twelve years of age – the condition has been considered untreatable because the brain wasn’t thought to be plastic enough,” said Benjamin Thompson of McGill University in Canada. “The main message here is to show that there really is plasticity in the adult visual system. There is real momentum now to find a treatment for adult amblyopia.”

Current treatments for children with amblyopia emphasize patching or otherwise penalizing their “good” eye before the age of twelve. By forcing the use of the amblyopic eye, children can often recover some function. However, after that critical window in childhood, no treatment has been widely available.

Thompson said the condition often goes unnoticed in children because they don’t realize there is a problem. Of the six million sufferers in the U.S., he said, most are adults. But there is good news: some studies have begun to show evidence of plasticity in the adult visual cortex of human and animal brains.

Thompson, along with Robert Hess and their colleagues, now shows that such plasticity can be released temporarily with just 15 minutes of repetitive transcranial magnetic stimulation (rTMS). The noninvasive treatment involves placing a handheld coil against the scalp that delivers a rapid train of magnetic pulses.

The researchers found that 15 minutes of rTMS therapy improved contrast sensitivity in patients’ amblyopic eyes for a period of at least 30 minutes. That improvement was measured by showing them two patches of grating, one with lots of fine detail and the other with thicker, easier-to-see lines. After rTMS, people needed less contrast to see those finer details than they had prior to treatment.

While it’s not entirely clear how rTMS works, it seems to change the balance of excitation and inhibition in the cortex, Thompson said, noting that the method is already in use for stroke rehabilitation and is being tested for use in those with depression.

He said that repeated doses of rTMS may allow for longer-lasting effects. The treatment might also prime the brain for training regimes in which adults are asked to perform series of visual tasks. Recent studies have suggested that such perceptual training can improve vision in amblyopic eyes.

The researchers include Benjamin Thompson, McGill Vision Research Department of Ophthalmology, Royal Victoria Hospital, Montreal, Quebec, Canada; Behzad Mansouri, McGill Vision Research Department of Ophthalmology, Royal Victoria Hospital, Montreal, Quebec, Canada; Lisa Koski, Royal Victoria Hospital, Montreal, Quebec, Canada; and Robert F. Hess, McGill Vision Research Department of Ophthalmology, Royal Victoria Hospital, Montreal, Quebec, Canada.

Source: Cathleen Genova

Cell Press

The National Institutes of Health has expanded a genetic and clinical research database to give researchers access to the first digital study images. The National Eye Institute (NEI), in collaboration with the National Center for Biotechnology Information (NCBI), has made available more than 72,000 lens photographs and fundus photographs of the back of the eye, collected from the participants of the Age-Related Eye Disease Study (AREDS).

These images are now accessible to scientists through NCBI’s online database of Genotypes and Phenotypes, known as dbGaP, which archives data from studies that explore the relationship between genetic variations (genotype) and observable traits (phenotype). Though study descriptions and protocols are publicly accessible, researchers must apply for controlled access to de-identified information about study subjects, including the new images.

“The availability of AREDS images through dbGaP may transform the way we conduct vision research,” said NEI director Paul A. Sieving, M.D., Ph.D. “Scientists can increase their understanding of the impact of genetics and gene-environment interactions on blinding eye disease progression, which could aid in diagnosis and in developing effective treatments.”

The NEI-supported AREDS was one of two studies included in the December 2006 launch of dbGaP. The first version of controlled-access AREDS information was made available in 2007, including data gathered from genome-wide scans of DNA samples from 600 study participants. The database was updated in November 2008 to include clinical trial and natural history information from the 4,757 total AREDS participants over 10 years. The latest addition to the AREDS dataset includes more than 72,000 lens and fundus photographs from 595 study participants with genome-wide scan data available.

“The National Center for Biotechnology Information is very pleased to be involved in this effort to provide researchers with access to the images from AREDS,” said NCBI director David Lipman, M.D. “Linking individual study subjects’ eye photographs with their phenotype and genotype data provides a valuable new dimension of information for researchers to explore in attempting to understand age-related eye disease.”

AREDS began in 1992 as a multi-center, prospective study designed to evaluate the progression of age-related macular degeneration and age-related cataract. Participants, who were age 55 to 80 when the study started, also enrolled in a clinical trial of high-dose vitamin and mineral supplements. They were followed for a median of 6.5 years during the trial and five years after the study ended. Beginning in 1998, DNA was also isolated from blood samples obtained from more than 3,700 AREDS participants.

“AREDS has been the main focus of the translational research program at NEI for a number of years,” said NEI clinical director Frederick L. Ferris III, M.D. “This new group of lens and fundus images from well-described study participants provides a new opportunity for vision research, and is a valuable resource for clinical teaching and training as well.”

Open-access AREDS data and a link to apply for controlled access to individual-level data, including the new images, can be found on the NEI-AREDS study page.

Source:
Jean Horrigan
NIH/National Eye Institute

Watering eye, also known as epiphora or tearing, is a condition in which there is an overflow of tears onto the face, often without a clear explanation. There is insufficient tear film drainage from the eye(s) – instead of all the tears draining through the nasolacrimal system, they overflow onto the face.

Epiphora can develop at any age. It is, however, more common among babies aged under 12 months, and adults over the age of 60 years. The condition may present symptoms in just one or both eyes.

In most cases watering eye can be treated effectively.

Depending on the severity of symptoms, watering eye can sometimes make driving difficult and dangerous.

According to Medilexicon’s medical dictionary, epiphora (tearing, watering eye) is:
“An overflow of tears on the cheek, due to imperfect drainage by the tear-conducting passages.”
What are the causes of epiphora (watering eye)?
There are two main causes of epiphora – blocked tear ducts or excessive production of tears.

Blocked tear ducts – some humans are born with underdeveloped tear ducts. It is not uncommon for newborns to have watery eyes. Generally, this problem goes away within a few weeks as the ducts develop.

The most common cause of watering eyes among adults and older children is blocked ducts, or ducts that are too narrow. Narrowed tear ducts usually become so as a result of swelling (inflammation).

If a patient’s tear ducts are narrowed or blocked their tears will not be able to drain away and will build up in the tear sac. Stagnant tears in the tear sac increase the risk of infection in that area and the eye will produce a sticky liquid, further exacerbating the problem. Infection can also lead to inflammation on the side of the nose, next to the eye.

Narrow drainage channels on the insides of the eyes (canaliculi) can become blocked. This is caused by swelling or scarring.
Over-production of tears – irritated eyes may produce more tears than normal as the body tries to rinse the irritant away. The following irritants can cause the over-production of tears:

Some chemicals, such as fumes, and even onions
Infective conjunctivitis
Allergic conjunctivitis
An injury to the eye, such as a scratch or a bit of grit (tiny pebble or piece of dirt)
Entropion (inward-growing eyelash)
Ectropion – this is when the lower eyelid turns outwards

The tears of some patients have a high fat (lipid) content. This may interfere with the even spread of liquid across the eye, leaving dry patches which become sore, irritated and cause the eye to produce more tears.
How is epiphora (watering eye) diagnosed?
Epiphora is a fairly easy condition for a GP (general practitioner, primary care physician), or any doctor to diagnose. The doctor will try to find out whether it has been caused by a lesion, infection, entropion (inward-growing eyelash) or ectropion (outward-turning eyelid).

If the GP cannot clearly determine the cause of the watering eye the patient may be referred to an eye-care specialist doctor (ophthalmologist). The specialist will examine the patient’s eye(s) carefully – usually, the patient will be anesthetized.

A probe might be inserted into the narrow drainage channels on the inside of the eye (canaliculi) to see whether they are blocked.

Liquid may be inserted into a tear duct to find out whether it comes out of the patient’s nose. If it is found to be blocked, a dye may be injected to find the exact location of the blockage – this will be done by using an X-ray image of the area. The dye shows up on the X-ray.
What is the treatment for watering eye?
Treatment options depend on the severity of the epiphora and its causes. In mild cases doctors may recommend just watchful waiting – doing nothing and monitoring the patient’s progress.

Treatment for irritation – if the watering eye is caused by infective conjunctivitis the doctor may prefer to wait for a week or so to see if the problem resolves itself without antibiotics.

When allergic conjunctivitis is the cause the patient may be prescribed an antihistamine, which is effective in bringing down the inflammation.
In cases of entropion – an inward-growing eyelash, or some foreign object that lodged in the eye, the doctor will remove it.
If the patient has ectropion – the eyelid turns outwards – the patient may need to undergo surgery in which the tendon that holds the outer eyelid in place is tightened.
Blocked tear ducts – surgery which creates a new channel from the tear sac to the inside of the nose may be necessary. This allows the tears to bypass the blocked part of the tear duct. This surgical procedure is called DCR (dacryocystorhinostomy).

If the drainage channels on the inside of the eye (canaliculi) are narrowed, but not entirely blocked, the doctor may use a probe to make them wider. When the canaliculi are completely blocked an operation may be required.
Epiphora (watering eye) in babies – in the majority of cases the condition resolves itself on its own within a few weeks. Sometimes a sticky liquid may form around the baby’s eye(s). In such cases, using a piece of cotton wool that has been soaked in sterile water can be used to clean the eye(s). Sterile water needs to be boiled – make sure it is cooled before dipping the cotton wool into it.

Sometimes tears can be dislodged if you gently massage the tear ducts. Apply light pressure with the finger and thumb to the outside of the baby’s nose.

Men suffer from nearly three times as many eye injuries as women, according to a survey conducted by the American Academy of Ophthalmology (Academy) and the American Society of Ocular Trauma (ASOT). The annual Eye Injury Snapshot, a clinical survey of eye injuries across the U.S., conducted from May 16 to May 23 this year, found that men suffered the majority (73.5 percent) of the eye injuries. Annually, 2.5 million Americans suffer eye injuries and more than 52 percent of all injuries are taking place at home.

“It is often the most common household chores and activities that can lead to devastating eye injuries,” said Randolph L. Johnston, MD, president of the Academy. “Taking the time to protect your eyes while performing these tasks is the easiest way to protect your sight.”

In an effort to prevent the most common eye injuries, the Academy and ASOT recommend that every household in America have at least one pair of ANSI-approved* protective eyewear to be worn when doing projects and activities at home.

This was the seventh year that data was collected for the Eye Injury Snapshot. Among the key findings:

– One in four of the eye injuries occurring at home were due to play/sports.

– Another 25 percent were due to home repair or power tools.

– The yard and garden were the places people were most likely to suffer an eye injury in the home.

– Nearly half of the injuries reported were to people between the ages of 30-64, while children 12 years of age or younger represented about 12 percent of the injuries.

– More than 40 percent of eye injuries occur between noon and 7 p.m.

Learn more about eye injuries, get names of Eye M.D.s in your area or ask an Eye M.D. a question by visiting here.

* ANSI-approved protective eyewear is manufactured to meet the American National Standards Institute (ANSI) eye protection standard. ANSI-approved protective eyewear can be easily purchased from most hardware stores nationwide and can be identified by the mark “Z87” placed on the eye wear. ANSI-approved protective eyewear is not approved for use in sports. To locate appropriate eyewear for specific sports talk to your ophthalmologist or visit here.

Source:

American Academy of Ophthalmology

There’s more to the eye makeup that gave Queen Nefertiti and other ancient Egyptian royals those stupendous gazes and legendary beauty than meets the eye. Scientists in France are reporting that the alluring eye makeup also may have been used to help prevent or treat eye disease by doubling as an infection-fighter. Their findings are scheduled for the next (Jan. 15, 2010) issue of the American Chemical Society (ACS) semi-monthly journal, Analytical Chemistry.

Christian Amatore, Philippe Walter, and colleagues note that thousands of years ago the ancient Egyptians used lead-based substances as cosmetics, including an ingredient in black eye makeup. Some Egyptians believed that this makeup also had a “magical” role in which the ancient gods Horus and Ra would protect wearers against several illnesses. Until now, however, modern scientists largely dismissed that possibility, knowing that lead-based substances can be quite toxic.

In earlier research, the scientists analyzed 52 samples from ancient Egyptian makeup containers preserved in the Louvre museum in Paris. They identified four different lead-based substances in the makeup. In the new study, they found that the substances boosted production of nitric oxide by up to 240 per cent in cultured human skin cells. Modern scientists recognize nitric oxide as a key signalling agent in the body. Its roles include revving-up the immune system to help fight disease. Eye infections caused by bacteria can be a serious problem in tropical marshy areas such as the Nile area during floods, the scientists note. Therefore, the ancient Egyptians may have deliberately used these lead-based cosmetics to help prevent or treat eye disease, the researchers suggest, noting that two of the compounds do not occur naturally and must have been synthesized by ancient Egyptian “chemists.”

The full text of their paper is available here. An excerpt follows:

“The present data thus establish that the eyes of Egyptians bearing the black makeup were presumably prone to immediately resist a sudden bacterial contamination with extreme efficiency through the spontaneous action of their own immune cells. Indeed, it is well recognized today that in most tropical marshy areas, such as was the Nile area during floods, several bacterial infections are transmitted to humans following any accidental projection of contaminated water drops into one’s eye. These data fully support that Horus’ and Ra’s protection that ancient Egyptians associated with this makeup and particularly with its laurionite component was real and effective, despite the fact that its “magic” implications seemed a priori totally irreconcilable with our modern scientific views and contrast with our present understanding of the toxicity of lead ions. One cannot evidently go as far as to propose that laurionite was purposely introduced into the composition of the makeup because of any recognized antibacterial properties. Yet, one can presume that ancient Egyptian “chemists” recognized empirically that whenever this “white precipitate” was present in the makeup paste, their bearers were enjoying better health and thus decided to amplify this empirical protective function by specifically manufacturing laurionite. Many examples of such subtle observations and medical conclusions that would have a priori been surprising can be found even in our recent history. It is sufficient, for example, to think about the historical origin of penicillin, aspirin, or quinine. . . Anyway, whether or not the manufacture of these lead chlorides was deliberately connected to preventive health care by Egyptians, it is clear that such intentional production remains the first known example of a large scale chemical process. It is no wonder that “kemej,” the Egyptian word that referred to the Egyptian land and to the black earth of the Nile valley, was handed to us via the Greeks and then the Arabs to eventually coin our present ‘chemistry’.”

CONTACT:

Christian Amatore, Ph.D.
Ecole Normale Sup?�rieure
D?�partement de Chimie
Universit?� Pierre et Marie Curie
Paris, France


or


Philippe Walter, Ph.D.
CNRS Research & Restoration Center of Museums
Paris, France

Source: Michael Bernstein

American Chemical Society

Six year old children with strabismus (visible squint) are much less likely to be invited to birthday parties than other children of the same age, says a study published in the British Journal of Ophthalmology. Study authors say that children with a squint should undergo corrective surgery before they are six years old – the age when discrimination seems to start.

The researchers digitally altered photos of 6 children from 6 identical twin pairs to create inward and outward types of visible squint (strabismus) to compare against normally aligned eyes.

118 children aged from 3 to 12 were asked to select which of the identical twins they would invite to their birthday party. The children in the photographs were either eye clinic patients or siblings of the patients.

They were asked to select four times, so that they had a chance of choosing faces of up to four children with strabismus (a squint). An average of two children with a squint would have been selected if squints made no difference to the choice.

The authors reported that several factors, such as gender, what color top they were wearing, or the type of squint made no difference to the likelihood of selection.

Children under the age of 6 years did not make any distinction between a twin with a squint and one without a squint.

However, children aged six years or more were much less likely to choose children with a visible squint.

48 of the children who were choosing were aged from 6 to 8:

18 of them did not chose one single child with a squint
17 of them selected a child with a squint just once
11 of them selected a child with a squint twice
2 of them selected a child with a squint three times
None of them selected a child with a squint four times

31 of the children who were choosing were aged between 4 and 6 years:

1 of them did not select one single child with a squint
21 of them selected a child with a squint once or twice
9 of them selected a child with a squint three or four times

When the selecting, the children were asked whether they had noticed anything particular about the twins:

19% of the 4 to 6 year olds mentioned eye alignment
39% of the 4 to 6 year olds mentioned eye alignment after being asked to focus on the eyes in the photographs
48% of the 6 to 8 year olds mentioned eye alignment
77% of the 6 to 8 year olds mentioned eye alignment after being asked to focus on the eyes in the photographs

The researchers say that a squint during childhood can have a long-term impact on the patient concerned and that “visible differences in general have a negative impact on how children are perceived by peers.”

The authors concluded:

Our results show that schoolchildren with strabismus seem less likely to be accepted by their peers, so corrective surgery for strabismus should be performed before the age of 6 years, when negative social implications may arise.

“Strabismus and discrimination in children: are children with strabismus invited to fewer birthday parties”

Stefania Margherita Mojon-Azzi, Andrea Kunz, Daniel Stephane Mojon
Online First Br J Ophthalmol 2010; doi 10.1136/bjo.2010.185793