Month: August 2014

The European Council of Optometry and Optics (ECOO) has called for patients with Down’s Syndrome and their carers to ensure that vision needs are regularly monitored after new research into the structure of the eye in people with Down’s Syndrome has found significant differences from the norm.

It is well known that people with Down’s Syndrome are more likely to suffer from eye conditions such as amblyopia (lazy eye), near or long-sightedness, and an increased risk of cataracts. This research demonstrates that patients often have problems with both the lens of the eye and the cornea and, despite correction through the use of spectacles, often fail to achieve optimum visual acuity.

A study carried out by Drs Julie-Anne Little and Kathryn J Saunders of the University of Ulster and Dr J Margaret Woodhouse of Cardiff University and published in Optometry and Vision Science (the journal of the American Academy of Optometry) has looked into the connection between corneal power and astigmatism in Down’s Syndrome.

Looking at a group of 29 Down’s Syndrome children and comparing them with a control group of 68 children of a similar age, the study found high levels of refractive error (poor sight), including astigmatism, in a significant percentage (59%) of the Down’s Syndrome children as opposed to 28% of the control group. 48% (versus 1% in the control group) were long-sighted, 10% (25%) short-sighted and 48% (6%) had astigmatism.

The report calls for further research into the connection between the ocular structures of the eye in Down’s Syndrome children and functional vision. The European Council of Optometry and Optics (ECOO) calls for people who have Down’s Syndrome to have regular sight tests so that they can be given the best possible correction for their needs.

Wolfgang Cagnolati, President of ECOO, said: “These are among the most vulnerable of our society. It is important that their carers should be aware of the increased risk that Down’s Syndrome sufferers have of eyesight problems. Proper care can bring a great improvement in vision to a group of people who find it difficult to recognise and articulate their own needs.”

Notes:
Corneal Power and Astigmatism in Down Syndrome was published in Optometry and Vision Science Vol 86 No.6
The European Council of Optometry and Optics is the European organisation which represents the interests of optometrists and opticians from 30 countries. It aims to promote eye health to the public across borders and to harmonise clinical and educational standards of optometric and optical practice throughout Europe.
Source
European Council of Optometry and Optics

A subretinal implant inserted under the retina of three blind people has allowed them to see shapes and objects within days of the procedure, German scientists report in the journal Proceedings of the Royal Society B. One of the patients surprised researchers by identifying and locating objects on a table; he was also able to walk around a room unaided, approach specific people, tell the time from a clock face, and describe seven different shades of gray in front of him.

The electronic visual prosthesis was developed by Retinal Implant AG, Germany and the Institute for Ophthalmic Research, University of Tuebingen, Germany. The authors describe it as an “unprecedented advance in electronic visual prostheses”.

This technology could change the lives of patients with retinitis pigmentosa – a degenerative eye disease affecting approximately 200,000 individuals globally.

Retinitis pigmentosa includes a group of inherited disorders in which abnormalities in the rods and cones in the retina – types of photoreceptors – lead to progressively worsening vision, and eventually total blindness. Patients initially suffer from night blindness, then tunnel vision in which their visual field becomes constricted, and eventually loss of central vision. Retinitis pigmentosa can occur alone or as part of a syndrome, such as Usher syndrome.

Founding Director of Retinal Implant AG, Dr. Eberhart Zrenner, said:

The results of this pilot study provide strong evidence that the visual functions of patients blinded by a hereditary retinal dystrophy can, in principle, be restored to a degree sufficient for use in daily life.

Dr. Zrenner is also Chairman of the University of Tuebingen Eye Hospital.

The subretinal implant is implanted under the retina and replaces the retina’s cones and rods – its light receptors – which were lost in retinal degeneration.

The authors explain:

It uses the eyes’ natural image processing capabilities beyond the light detection stage to produce a visual perception in the patient that is stable and follows their eye movements.

Unlike epiretinal implants which are placed outside the retina and do not use the integral light-sensitive structures in the eye, this subretinal implant does not require the patient to wear an external camera and processor.

Because this subretinal implant has considerably more light receptors than any other similar device, it gives the patient unequaled visual clarity.

Prof. Dr. Zrenner wrote:

The present study..presents proof-of-concept that such devices can restore useful vision in blind human subjects, even though the ultimate goal of broad clinical application will take time to develop.

Zrenner and team tested the device on 11 individuals. Some of them experienced no benefit because their condition had progressed too far, the researchers wrote. However, the others were able to detect bright objects and shapes.

Best results were achieved when they placed the device further behind the retina – in the central macula area. This they did with three patients.

David Head, Chief Executive at RP (Retinitis pigmentosa) Fighting Blindness, said:

This technology is very exciting; Prof Zrenner is highly respected and should be congratulated on this work. However these devices are at an early stage of development as this report notes, and it’s important that we recognize that from early trials to a product that is fully proven and generally available can take a long time.

We look forward to the results of further follow up work in Oxford and other centers and we and our members will be monitoring developments with great interest.

The authors concluded in Proceedings of the Royal Society B:

These results demonstrate for the first time that subretinal micro-electrode arrays with 1500 photodiodes can create detailed meaningful visual perception in previously blind individuals.

“Subretinal electronic chips allow blind patients to read letters and combine them to words”
Eberhart Zrenner, Karl Ulrich Bartz-Schmidt, Heval Benav, Dorothea Besch, Anna Bruckmann, Veit-Peter Gabel, Florian Gekeler, Udo Greppmaier, Alex Harscher, Steffen Kibbel, Johannes Koch, Akos Kusnyerik, Tobias Peters, Katarina Stingl, Helmut Sachs, Alfred Stett, Peter Szurman, Barbara Wilhelm, Robert Wilke
Proceedings of the Royal Society B Published online before print November 3, 2010
doi: 10.1098/rspb.2010.1747

Bausch & Lomb, a world leader in eye health, today announced that the U.S. Food and Drug Administration (FDA) approved Besivance™ (besifloxacin ophthalmic suspension) 0.6% for the treatment of bacterial conjunctivitis, commonly referred to as “pink eye.” Besivance™ is a new topical ophthalmic anti-infective, administered via sterile ophthalmic drops, that treats a wide range of eye pathogens including those that most commonly cause bacterial conjunctivitis.4 Bacterial conjunctivitis is one of the most common ocular conditions worldwide. 2

In December 2008, an FDA Advisory Committee voted unanimously to recommend approval of Besivance.

Besivance is the first fluoroquinolone specifically developed for ophthalmic use and is the first and only ophthalmic fluoroquinolone with no previous systemic use. It offers broad-spectrum antibacterial activity, including activity against the strains that are the most common causes of bacterial conjunctivitis.3

“Topical ophthalmic besifloxacin offers physicians the opportunity to provide patients with an anti-infective that treats a broad range of bacterial ocular pathogens,” said Marguerite McDonald, MD, FACS, Clinical Professor of Ophthalmology at NYU School of Medicine, New York, New York.

The FDA approval of Besivance was based on a series of eight clinical trials. These studies were designed to test the efficacy, safety, tolerability, pharmacokinetics and pharmacodynamics with the topical anti-infective. Its efficacy was evaluated in three multi-center, randomized, double-masked trials involving nearly 2,400 patients with a clinical diagnosis of bacterial conjunctivitis. In clinical trials, investigators found that Besivance treatment resulted in a greater proportion of patients experiencing clinical resolution and microbial eradication, when compared to its vehicle.4

“Today’s FDA approval of Besivance provides patients with an advanced therapy that can eradicate bacterial conjunctivitis at its source both safely and effectively,” said Flemming Ornskov, M.D., M.P.H., corporate vice president and global president, Pharmaceuticals, Bausch & Lomb. “At Bausch & Lomb we are committed to developing innovative eye health products that help enhance patients’ overall quality of life, and we are pleased to offer the medical community a new treatment option for this exceedingly common condition.”

Besivance will be available by prescription in U.S. pharmacies in the second quarter of 2009. Besivance will be promoted by both the Bausch & Lomb and Pfizer, Inc. sales forces.

About Bacterial Conjunctivitis

Conjunctivitis is one of the most common eye diseases seen worldwide.2 Often referred to as “pink eye,” bacterial conjunctivitis is an infection of the conjunctiva, the outer-most layer of the eye that covers the white part of the eye. 5 This contagious disease occurs in patients of all ages. Typical signs include a red eye and discharge that persists throughout the day.6 The acute form of contagious conjunctivitis is most frequently seen in infants, schoolchildren and the elderly, generally as a result of bacterial or viral infections.2 Acute red eyes, most frequently diagnosed as acute bacterial conjunctivitis, account for 1 to 4 percent of all physician visits in the developed world. 2

About Besivance

Besivance (besifloxacin ophthalmic suspension) 0.6%, is indicated for the treatment of bacterial conjunctivitis in patients one year and older, caused by susceptible isolates of the following bacteria: CDC coryneform group G, Corynebacterium pseudodiphtheriticum*, Corynebacterium striatum*, Haemophilus influenzae, Moraxella lacunata*, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus hominis*, Staphylococcus lugdunensis*, Streptococcus mitis group, Streptococcus oralis, Streptococcus pneumoniae, Streptococcus salivarius.* The asterisk denotes efficacy for these organisms was tested in fewer than 10 infections.

Besivance is for topical ophthalmic use only, and should not be injected subconjunctivally or directly into the anterior chamber of the eye.4 As with other anti-infectives, prolonged use of Besivance may result in overgrowth of non-susceptible organisms, including fungi. If super-infection occurs, discontinue use and institute alternative therapy.4 Although Besivance is not intended to be administered systemically, quinolones administered systemically have been associated with hypersensitivity reactions, even following a single dose. Patients should be advised to discontinue use immediately and contact their physician at the first sign of a rash or allergic reaction.4 The most frequently reported adverse event in clinical studies was conjunctival redness, reported in approximately 2% of patients. Other adverse events reported in approximately 1-2% of patients included blurred vision, eye pain, eye irritation, eye pruritus and headache.4 The safety and effectiveness of Besivance in infants below one year of age has not been established.4

Please see accompanying full prescribing information for Besivance.

About Bausch & Lomb

Bausch & Lomb is the eye health company dedicated to perfecting vision and enhancing life for people around the world. Its core businesses include contact lenses and lens care products, ophthalmic surgical devices and instruments, and ophthalmic pharmaceuticals. The Bausch & Lomb name is one of the best-known and most respected healthcare brands in the world. Founded in 1853, the company is headquartered in Rochester, N.Y., and employs more than 10,000 people worldwide. Its products are available in more than 100 countries. More information is available at bausch.

About Pfizer Ophthalmics

Pfizer Ophthalmics, part of Pfizer’s Specialty Care business unit, is committed to preserving sight and eliminating preventable blindness and expanding its portfolio through licensing and partnerships. Pfizer Ophthalmics discovers, develops and provides leading treatments in ophthalmology to support patients who are at risk of blindness or suffering from vision impairment, and to serve the health care professionals who treat them.

Reference

1. Cavuoto K, Zutshi D, Karp CL, et al. Update on bacterial conjunctivitis in South Florida. Ophthalmology 2008;115:51-6.

2. Hovding G. Acute bacterial conjunctivitis. Acta Ophthalmol 2008;86:5-17.

3. Karpecki, P, DePaolis, M, Hunter, J, et al. Besifloxacin Opthalmic Suspension 0.6% in Patients with Bacterial Conjuntivitis: A Multicenter, Prospective, Randomized, Double-Masked, Vehicle-Controlled, 5-Day Efficacy and Safety Study. Clinical Therapeutics 2009: 31:3-11

4. Besivance™ Prescribing Information

5. MedicineNet, Facts About “Pink Eye”. Available here. Accessed 3/26/2009.

6. Tarabishy, A, Jeng, B. Bacterial Conjunctivitis: A Review for Internists. Cleveland Clinical Journal of Medicine. 2008: 75:7-507.

Source
Bausch & Lomb

View drug information on Besivance.

The U.S. Food and Drug Administration (FDA) Dermatologic and Ophthalmic Drugs Advisory Committee today voted unanimously to recommend approval of Bausch & Lomb’s besifloxacin ophthalmic suspension, 0.6%, for the treatment of bacterial conjunctivitis. The company has developed this broad-spectrum, anti-infective drop specifically for ophthalmic use.

All new chemical entities such as besifloxacin, a fluoroquinolone, must be reviewed by an FDA advisory committee as part of the approvals review process for new drug applications.

“We are encouraged by this morning’s committee discussion and vote, and look forward to continue working with the FDA to gain final approval,” said Flemming Ornskov, M.D., M.P.H., corporate vice president and global president, Pharmaceuticals, Bausch & Lomb. “Our intent remains to bring this innovative product to market, beginning in the U.S., in 2009.”

About Bausch & Lomb

Bausch & Lomb is the eye health company dedicated to perfecting vision and enhancing life for people around the world. Its core businesses include contact lenses and lens care products, ophthalmic surgical devices and instruments, and ophthalmic pharmaceuticals. The Bausch & Lomb name is one of the best known and most respected healthcare brands in the world. Founded in 1853, the company is headquartered in Rochester, N.Y., and employs approximately 13,000 people worldwide. Its products are available in more than 100 countries. More information is available at bausch.

The search for ways to protect polymer-based medical implants — used in devices ranging from contact lenses to artificial hearts, as well as surgical devices and operating room equipment — from bacterial infections has led scientists in Mississippi to develop a penicillin-coated version of a key polymer biomaterial.

In a report scheduled for the Feb. 12 edition of ACS’ Biomacromolecules, a monthly journal, Marek W. Urban and colleagues describe a new way to modify expanded poly(tetrafluorethylene), or ePTFE, so that penicillin adheres to its surface and remains highly effective. This polymer is used in medical procedures ranging from vascular grafting to plastic and reconstructive surgery. In laboratory experiments, the researchers also demonstrated that the penicillin-coated surfaces showed highly effective antibacterial activity against Staphylococcus aureus, which causes many serious human infections.

The researchers believe this is the first study to report such activity. “This approach may serve as a general surface modification process for the development of polymeric surfaces with anti-microbial properties,” their report states.

ARTICLE #4
“Antibacterial Surfaces on Expanded Polytetrafluoroethylene; Penicillin Attachment”

CONTACT:

Marek W. Urban, Ph.D.
The University of Southern Mississippi
Hattiesburg, Mississippi

ACS News Service Weekly PressPac — Jan. 17, 2007

The American Chemical Society — the world’s largest scientific society — is a nonprofit organization chartered by the U.S. Congress and a global leader in providing access to chemistry-related research through its multiple databases, peer-reviewed journals and scientific conferences. Its main offices are in Washington, D.C., and Columbus, Ohio.

Contact: Michael Woods

American Chemical Society

Blue Cross and Blue Shield of Georgia (BCBSGa) and OneSight, a Luxottica Group Foundation, have partnered to bring the OneSight Vision Van, “SeeMore” to Georgia from January 21 to 23. Henry County Schools pre-selected more than 300 students from kindergarten through high school based on their financial and vision needs to receive free vision care, including full vision exams and new eyewear. Held at the Luxottica Retail Distribution Center (100 Greenwood Industrial Pkwy, McDonough, GA 30253), local doctors, community partners, BCBSGa associates and brokers, as well as employees from LensCrafters, Sunglass Hut, Pearle Vision, Sears Optical and Target Optical will provide care and assistance during clinic hours (8:30 AM to 4:30 PM daily).

According to Prevent Blindness America, one in four school-aged children has visual disabilities that affect their ability to learn. Approximately 80 percent of all learning during a child’s first 12 years is obtained through the eyes; yet 86 percent of children do not receive a vision exam during that time.

“This collaborative effort to bring the Vision Van to the greater Atlanta area will help make a meaningful difference in the lives of children who might not otherwise have had their vision needs met,” says Monye Connolly, president, BCBSGa. “Our hope is that this service will provide these children with improved self-esteem and a better opportunity to live life to the fullest.”

“OneSight provides important opportunities that help children succeed in school and, ultimately, in life,” said Jane Walters, OneSight Captain. “We have seen many cases where a pair of glasses has made the difference in helping a child accomplish greater scholastic success or simply see clearly for the first time. Watching a child’s face light up as the world comes into focus is something I will never forget.”

OneSight (formerly known as Give the Gift of Sight Foundation), a Luxottica Group Foundation, is a family of charitable programs dedicated to improving vision for those in need worldwide through outreach, research and education. OneSight has been serving the McDonough, GA area since 2003 and during the past six years approximately 400 Henry County children have received free eye care and nearly 95 percent of these local children required and received free prescription eyewear.

“An eye exam is one of the best forms of preventative medicine today. Good vision health is connected to overall health and well-being. Supporting the Vision Van helps these children to more clearly experience the world around them,” said Stuart Watts, regional vice president of BCBSGa’s Specialty Sales, which includes the Vision business.

The BCBSGa Blue View Vision network includes ophthalmologists, optometrists, and opticians. In addition to private practitioners, Blue View Vision’s broad national network includes retailers like LensCrafters(R), Target(R) Optical, JCPenney(R) Optical, Sears Optical and Pearle Vision locations. BCBSGa’s Blue View Vision product offers access to more than 44,000 providers nationwide and more than 600 providers in Georgia. Under Blue View Vision, kids ages 19 and under get full coverage of Transitions(R) and polycarbonate lenses.

In addition to serving children in communities throughout the country with the Vision Van, OneSight also performs two-week Global Clinics designed to hand-deliver eye exams and recycled, donated eyewear to underprivileged individuals in developing countries. To date, nearly 3 million people have been helped during Global Clinics.

About OneSight

OneSight, a Luxottica Group Foundation and a non-profit 501(c)(3) corporation, is a family of charitable programs dedicated to improving vision for those in need worldwide through outreach, research and education. OneSight’s outreach programs include the hand-delivery of vision care and eyewear to those in need. Since 1988, OneSight outreach efforts have helped more than six million people around the world see more clearly. OneSight also supports research and education, granting more than $6 million towards vision preservation and thousands of dollars in scholarships to students pursuing a degree in Optometry. Luxottica Group (a global leader in eyewear manufacturing, distribution and retail) employees, Luxottica-affiliated and independent doctors, vendors, donors and other charitable partners worldwide, work together to give the gift of sight to those in need. Luxottica Group provides inspiration for OneSight and it is the foundation’s main sponsor. For more information visit onesight.

About Blue Cross and Blue Shield of Georgia:

Blue Cross and Blue Shield of Georgia, Inc. and Blue Cross and Blue Shield Healthcare Plan of Georgia, Inc. are independent licensees of the Blue Cross and Blue Shield Association(R) . The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Additional information about Blue Cross and Blue Shield of Georgia is available at bcbsga.

Blue Cross and Blue Shield of Georgia
bcbsga

Eat right. Exercise. Monitor blood sugar. Take medication regularly. This is the advice physicians give the more than 20 million Americans affected with diabetes. Yet implementation of these recommendations is often far from ideal, putting patients at greater risk for damage to the heart, kidneys, eyes, and feet.

In an effort to close this gap, the American College of Physicians (ACP) and the American College of Physicians Foundation (ACPF) are unveiling three practical tools for practicing internists who are ACP members, other healthcare professionals on clinical practice teams, and their patients.

These comprehensive educational tools are the culmination of an ambitious three-year Diabetes Initiative funded by an unrestricted educational grant from Novo Nordisk.

“The goals of providing these resources,” said Vincenza Snow, MD, FACP, Director, Clinical Programs and Quality of Care at ACP, “are to increase awareness of the gap between current practice and acceptable standards of diabetes care; provide educational interventions to improve diabetes care; increase physician awareness of what constitutes high quality, evidence-based diabetes care; and recognize medical practices that improve their diabetes care.”

The following materials are designed to help physicians and their staff to implement team-based care strategies, provide them with practical tools and motivate patients to implement lifestyle changes and self-management techniques.

* Living With Diabetes: An Everyday Guide for You and Your Family is an innovative model for patient education and empowerment. This self-management guide for patients covers diet, exercise, monitoring blood sugar, insulin, and other medications. Available with text in English or Spanish, Living With Diabetes is written in a conversational tone at a fifth-grade reading level and includes photographs of patients with diabetes and their families. It gives practical tips and concrete examples of successful approaches to control diabetes. Patients can get a copy of Living With Diabetes from their internist.

* The ACP Diabetes Care Guide for physicians and practice teams is intended to be used by multi-disciplinary teams providing care to patients with diabetes. It has two components: a printed practice manual (including special tools for better management of practice and patients) and a CD-ROM containing electronic versions of the manual and tools and 81 multiple-choice questions, answers, and critiques. One hundred thousand (100,000) copies of the guide will be distributed free to internal medicine physicians (including generalists and endocrinologists), nurses (including nurse practitioners), physician assistants, and diabetes educators (including nurses and dietitians). Health care professionals can use the guide to earn continuing education credits.

* The Diabetes Portal (diabetes.acponline/) is a free Web-based resource for physicians and patients that provides tools, resources, and research supporting diabetes care. Patients and clinicians can access information specific to their needs. Clinicians can search for information under the headings of quality improvement, practice issues, and clinical topics. Information and links are updated regularly, providing clinicians and patients with the latest evidence-based guidance. Patient resources include information about eye, foot, heart, and kidney complications caused by diabetes, as well as portions of both the patient and physician guides listed above.

Both Living with Diabetes and the ACP Diabetes Care Guide can be ordered at diabetes.acponline/ and are free to ACP members.

“Diabetes is a dangerous disease that is growing annually,” said Lynne M. Kirk, MD, FACP, president of ACP. “ACP and ACPF designed these resources – based on best-practices and evidence-based clinical guidance – to engage both physicians and patients to improve diabetes care in the United States.”

In addition to the three Diabetes Initiative resources, a free CD-ROM of all diabetes-related presentations given at the previous three internal medicine annual meetings (2005-2007) will be distributed to ACP members. The CD-ROM will have audio and synchronized PowerPoint slides from the presentations and will allow users to share this educational program with other members of their diabetes care team.

About ACP and ACPF The American College of Physicians (acponline/) is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 120,000 internal medicine physicians (internists), related subspecialists, and medical students. Internists specialize in the prevention, detection, and treatment of illness in adults.

The ACP Foundation (foundation.acponline/), incorporated in 1999, supports the mission of ACP and strives to enhance professionalism and to improve the health and welfare of patients and society through initiatives that provide patients with the information they need to understand and manage their health.

Contact: Steve Majewski

American College of Physicians

Researchers in Germany have developed a retinal implant that has allowed three blind people to see shapes and objects within days of the implant being installed. Impressively, one blind person was able to identify and find objects placed on a table in front of him, as well as walking around a room independently and approaching people, reading a clock face and differentiating seven shades of grey. The research is published in Proceedings of the Royal Society B.

The device, which has been developed by the company Retinal Implant AG together with the Institute for Ophthalmic Research at the University of Tuebingen, represents an unprecedented advance in electronic visual prostheses and could eventually revolutionise the lives of up 200,000 people worldwide who suffer from blindness as a result of retinitis pigmentosa, a degenerative eye disease.

In this disease light receptors in the eye cease to function. Writing in Proceedings of the Royal Society B, Prof. Dr. Eberhart Zrenner (founding Director of Retinal Implant AG and Director and Chairman of the University of Tuebingen Eye Hospital) states that “The results of this pilot study provide strong evidence that the visual functions of patients blinded by a hereditary retinal dystrophy can, in principle, be restored to a degree sufficient for use in daily life.”

The device – known as a subretinal implant – sits underneath the retina, directly replacing light receptors lost in retinal degeneration. As such, it uses the eyes’ natural image processing capabilities beyond the light detection stage to produce a visual perception in the patient that is stable and follows their eye movements. Other types of retinal implants – known as epiretinal implants – sit outside the retina and because they bypass the intact light-sensitive structures in the eyes they require the user to wear an external camera and processor unit.

The subretinal implant described in this paper achieves unprecedented clarity because it has a great deal more light receptors than other similar devices. As Prof. Dr. Zrenner states, “The present study…presents proof-of-concept that such devices can restore useful vision in blind human subjects, even though the ultimate goal of broad clinical application will take time to develop.”

Source:

Royal Society

Retina Implant AG

Rural Americans were five times more likely than urban residents to be treated in emergency departments for eye injuries in 2008, according to the latest News and Numbers from the Agency for Healthcare Research and Quality.

The federal agency found that rural Americans made 646 visits to hospital emergency departments per 100,000 people in 2008, compared to 120 visits per 100,000 people by those in urban areas. People in the Northeast were the most frequently seen in emergency departments for eye injury (256 visits per 100,000 people) and those in the West the least (156 visits per 100,000 people). The Midwest and South fell in between – 242 visits and 200 visits per 100,000 people, respectively.

AHRQ also found that for patients treated in the emergency department and released in 2008 (97 percent of all patients treated for eye injuries):

– The three most common types of the roughly 637,000 eye injuries were cornea scratches (50 percent), followed by cuts to the eyelid or around the eye (9 percent), and bruises around the eye (7 percent).

– Of these injuries, 32 percent were caused by being hit in the eye by something or someone, falling down (9 percent), getting a caustic substance in the eye (4 percent), insect bites or other reasons (3 percent), or being in a motor vehicle accident (nearly 3 percent).

– For the 3 percent of patients admitted to the hospital for eye injuries in 2008:

– The most common types of injuries were wounds to the tear glands (17 percent), bruised eye sockets (15 percent), and bruised eyelids (11 percent).

– Falls were the major cause of these injuries (36 percent), followed by motor vehicle accidents (19 percent), being hit by something or somebody (12 percent), other reasons including insect bites (3 percent), and getting burned by a caustic substance (1 percent).

This AHRQ News and Numbers summary is based on data from Emergency Department Visits Related to Eye Injuries, 2008. The report uses data from the agency’s 2008 Nationwide Emergency Department Sample.

Source:

Agency for Healthcare Research and Quality

The interplay between genetic predisposition and exposure to modifiable risk factors can multiply the risk for age-related macular degeneration, according to a report in the January issue of Archives of Ophthalmology, one of the JAMA/Archives journals.

Age-related macular degeneration (AMD) can cause blindness and is known to have both genetic and environmental risk factors, according to background information in the article. Researchers have previously found that a mutation in the gene for complement factor H (CFH) is associated with AMD, as is a mutation in the gene LOC387715. Because these mutations are common in the white population, it is likely that other factors–such as obesity and smoking–may modify the risk for AMD. “Elucidation of these modifying factors may increase understanding of disease pathogenesis and suggest lifestyle changes that may prevent AMD or delay the disease onset in carriers of predisposing genetic variants,” the authors write.

Debra A. Schaumberg, Sc.D., O.D., M.P.H., of Brigham and Women’s Hospital and Harvard Medical School, Boston, and colleagues compared 457 men and women with AMD (cases) to 1,071 controls who were the same age and sex as the cases but did not have AMD. All of the individuals were part of either the Nurses’ Health Study, a large examination of female registered nurses who were between the ages of 30 and 55 years in 1976, or the Health Professionals Follow-up Study, which includes male U.S. health care professionals who were ages 40 to 75 in 1986. The participants were examined when they enrolled in the studies and completed a follow-up questionnaire every two years; average age at AMD diagnosis was 68.7 years.

Blood samples were also collected for a genetic analysis. Information about CFH was available for 437 AMD cases and 1,015 controls, while information about LOC387715 was available for 445 AMD cases and 1,041 controls. Compared with those who had two normal copies of each gene (alleles), those who had two mutated alleles of both genes were 50 times more likely to develop AMD.

Individuals who carried two mutant alleles of the CFH gene and were not obese were four times as likely as non-obese individuals with two normal alleles to develop AMD. If those individuals also smoked, their risk was 8.69 times as great as non-smoking non-carriers. If individuals were obese and carried two mutant alleles of the CFH gene, their risk increased 12 times as compared with non-obese non-carriers. For LOC387715, risk increased by 6.33 times for those with two mutated alleles who did not smoke and 22.47 times for those with two mutated alleles who did smoke. The genetic risk factors were not affected by other risk factors associated with AMD, including regular aspirin use, fruit intake, fatty acid ratios or alcohol consumption.

Because these genetic mutations are so common, some have questioned the utility of widespread screening for AMD risk, the authors write. “The existence of interactions with modifiable lifestyle factors may provide further impetus for screening individuals who are at potentially greater risk [for AMD], for example, cigarette smokers or the obese,” they continue. “Knowledge of the substantial risk of AMD among individuals homozygous for either or both of these major AMD-associated variants might help motivate these individuals to stop smoking, lose weight, modify other risk factors and have regular eye examinations.”

(Arch Ophthalmol. 2007;125:55-62.)

This study was supported in part by grants from the National Institutes of Health. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Contact: Lori J. Shanks
JAMA and Archives Journals