Eye Care Medical Blog

Scientists have found that free radicals (unstable molecules that cause the death of cells as the body ages) may also cause the damage in the eyes of patients with Fuchs Endothelial Corneal Dystrophy (FECD), a hereditary disease that is one of the most common reasons for corneal transplants worldwide.

The finding, published in the November 2010 American Journal of Pathology, holds promise for early and preventative treatments for this disease, which impacts nearly four percent of the population over age 60.

“Our discovery is significant, because it gives us the first hope for slowing the progression of the disease,” says Dr. Ula V. Jurkunas, the principal investigator of the study, who is a scientist at Schepens Eye Research Institute and a corneal surgeon at Massachusetts Eye and Ear Infirmary in Boston. “If we can identify how free radicals are involved in this and what antioxidants can fight them, we can create a regimen that can help protect the cornea,” she adds. (Antioxidants are molecules such as vitamins or certain proteins that bind with and neutralize free radicals.)

FECD destroys cells in the endothelial or deepest layer of the cornea, which is the clear tissue that makes up the front portion of the eye. These endothelial cells are equipped with pumps that expel excess water from the cornea and keep it clear. Without these cells, the cornea swells and vision clouds, and, in the late stages, vision is completely blocked.

Because corneal endothelial cells do not regenerate themselves, the only effective treatment for Fuchs has been corneal transplant, in which a surgeon removes the injured layer and replaces it with the donor endothelium.

While scientists have made progress in identifying some genes that cause the disease, they have made little or no progress in defining the mechanisms at play.

As a surgeon who performs hundreds of transplants, Jurkunas began to believe that a free radical process might be part of what is happening within the Fuchs dystrophy-plagued cornea. Free radicals are unstable molecules released by the body, which destabilize other molecules through a process known as oxidization, which causes cell death. Antioxidants are known to bind with and neutralize free radicals.

To test the theory, Jurkunas and her colleagues took numerous tissue samples from patients undergoing corneal transplants and tested them for evidence of free radical oxidation and subsequent tissue damage.

In the significant majority of specimens, the scientists found that the level of antioxidants was less than normal (or down-regulated). They also found evidence of high rates of damage to the cells’ DNA, which is particularly susceptible to free radicals.

According to Jurkunas, the next step is to identify the specific antioxidants that would neutralize the free radicals involved in the damage and, therefore, could prevent or block their destructive action.

What should patients do in the meantime? While no conclusions should be drawn from these early results, Jurkunas recommends that patients at risk for Fuchs eat a healthy diet rich in leafy green vegetables, such as broccoli and Brussels sprouts, take multivitamins and wear UV protection outdoors.

Other scientists involved in the study are: Dr. Maya S. Bitar, Dr. Toshinari Funaki, and Dr. Behrooz Azizi, also from both Schepens Eye Research Institute and Massachusetts Eye and Ear Infirmary.

The study was conducted at Jurkunas’ laboratory at Schepens Eye Research Institute. Tissue samples were donated by the surgeons and patients of the Massachusetts Eye and Ear Infirmary and Ophthalmic Consultants of Boston.

Source: Schepens Eye Research Institute

The Optical Society of America’s (OSA) Annual Meeting, Frontiers in Optics 2006, will cover the breadth of optical science and engineering. This meeting, co-located with Laser Science XXII, the annual meeting of the American Physical Society (APS) Division of Laser Science, unites these communities for five days of cutting-edge content, powerful networking and opportunities for scientific exchange. Exhibits featuring 80+ leading optics companies will complement the in-depth educational programming and offer attendees a glimpse of the latest optical technologies and products.

WHAT: The Optical Society of America’s Annual Meeting – Frontiers in Optics 2006

WHERE: Rochester Convention Center, Rochester, New York, USA

WHEN: Sunday, October 8 – Thursday, October 12

WHY COME – PROGRAM HIGHLIGHTS: Frontiers in Optics 2006 marks 90 years of optics innovation as the 90th Annual Meeting of the Optical Society of America. Highlights include:

*
Frontiers in Optics plenary session will focus on timely global issues, highlighting solutions in optics.

Featured sessions are:

* The Energy Problem and What We Can Do About It, Steven Chu, Nobel Laureate, 1997 Nobel Prize in Physics, Lawrence Berkeley Natl. Lab, USA

* Optics Meets Alzheimer’s Disease: Seeing the Way to a Cure, Lee Goldstein, Harvard Medical School, USA

Technical topic highlights include:

* The use of photon imaging to monitor blood flow in mice after stroke

* Advances in imaging the eye in optical exams and studies of the eye; improved retinal imaging and eye examinations for people with diabetic retinopathy, an eye disorder that strike 40-45 percent of those diagnosed with diabetes

* New methods of producing 3-D images in displays without the need for special glasses

* Prototype system that produces color images in an endoscope, used in examinations of the esophagus and colonoscopies

* A new technique using light to determine blood flow in human brain tumors

* Award Session to recognize industry thought leaders

* “What’s Hot in Optics Now” session highlighting trends across the entire field of optics including biology and medicine, information science, vision and color and optical sciences

* Women in Optical Society of America (WOSA) luncheon with keynote speaker Meg Moulton from the National Coalition of Girls’ Schools on the state of female science education

* “Best of Topicals” session highlighting one stand-out paper from each of OSA’s 2006 meetings

* FiO Special Symposia tribute honoring Emmett Leith, pioneer of practical holography

* Educator’s Programs designed to expose middle and high school science teachers to the world of optics through materials, equipment and training in a hands-on environment with optics professionals. Hands-on activities and demonstrations for children of all ages.

Contact: Keira Shein

Optical Society of America

Medical researchers at the University of Alberta have unlocked part of the mystery underlying a childhood eye disease. New research shows how children with some types of glaucoma end up with missing or extra pieces of DNA.

The missing or extra bits of DNA are called copy number variations (CNVs). The U of A research team had previously shown how they play a major role in causing some types of pediatric glaucoma – a disease that can lead to blindness. In their current study, published in Human Molecular Genetics, the authors describe how the CNVs that cause childhood glaucomas are formed.

Using genetic samples from patients living with pediatric glaucoma, the research team studied the locations where extra or missing pieces of DNA begin and end. Close examination of these break points allowed the team to determine how these copy number variations occur.

“Our findings broaden the mechanisms known to cause copy number variations, which improves our understanding not only of pediatric glaucoma, but also of the growing number of genetic diseases linked to copy number variations, including heart disease and psoriasis. We’re really only looking at the tip of the iceberg in terms of how CNVs cause disease.” said Dr. Ordan Lehmann, an associate professor with the Faculty of Medicine & Dentistry at the University of Alberta and an ophthalmologist with Alberta Health Services. “These findings will also help us to improve the detection of pediatric glaucoma and, by allowing earlier diagnosis, will help lead to earlier treatment of this condition.”

The research team has received funding from the Emerging Research Teams Grant Program, which was created by the Faculty of Medicine & Dentistry and Alberta Health Services to provide startup money to promising research groups.

The study was undertaken in collaboration with researchers at the University of Chicago, the Wellcome Trust Sanger Institute, the Leicester Royal Infirmary and the UCL Institute of Child Health.

Dr. Ordan Lehmann is a member of the Team to Prevent Blindness Their objective is to develop a ground-breaking program of research into major causes of blindness. The team is online at: eyeteam.med.ualberta/.

The Faculty of Medicine & Dentistry at the University of Alberta is a leader in educating and training exceptional practitioners and researchers in the highest international standards. Our goal is to optimize health and wellness. We do this by providing an environment that nurtures continuous learning, scholarship, excellence and respect. We are home to 21 departments, 10 divisions, and many centres and institutes. For more information, please visit med.ualberta/.

Source: Lindsay Elleker

University of Alberta Faculty of Medicine & Dentistry

Exposure to prolonged temperature elevation reduces antifungal activity of a contact lens solution that was implicated in the epidemic of the eye infection Fusarium keratitis that occurred between 2004 and 2006, according to a report in the November issue of Archives of Ophthalmology, one of the JAMA/Archives journals.

Bausch & Lomb introduced ReNu with MoistureLoc, which contains an antimicrobial agent not found in other solutions, in August 2004, according to background information in the article. The first cases of Fusarium keratitis related to ReNu with MoistureLoc were reported to the U.S. government in March 2006; total of 154 confirmed cases were identified in the United States. “Bausch & Lomb investigators acknowledged that all original cases appear to be related to ReNu with MoistureLoc produced in their Greenville, S.C., plant,” the authors write.

According to the article, in 2006, the Food and Drug Administration (FDA) inspected this facility and cited Bausch & Lomb for inadequate temperature control in the production, storage and transport of products produced there. To assess what effect temperature might have on the growth of Fusarium fungus, John D. Bullock, M.D., M.P.H., M.Sc., of the Wright State University Boonshoft School of Medicine, Dayton, Ohio, and colleagues studied six contact solutions, including ReNu with MoistureLoc. “Two bottles of each solution were separately stored at room temperature and 60 degrees Celsius [140 degrees Fahrenheit] for four weeks, serially diluted and then tested for their ability to inhibit growth of 11 Fusarium isolates (seven of which were associated with the keratitis epidemic),” the authors write.

After the 60-degree storage, ReNu with MoistureLoc demonstrated the greatest decline in anti-fungal activity, while Clear Care and ReNu MultiPlus performed the best. When considering just the strains of Fusarium associated with the keratitis epidemic, ReNu with MoistureLoc that was stored at room temperature allowed fungal growth in 27 of 84 combinations (different blends of isolates grown in different solutions and at different levels of dilution), compared with 67 of 84 combinations for the bottle stored at 140 degrees Fahrenheit.

“The precise temperature, duration of exposure to elevated temperature and extent of temperature fluctuation that may diminish the antimicrobial activity of a particular contact lens solution is not known, and thus, additional studies may be warranted. However, our findings, coupled with the FDA reports of Bausch & Lomb’s failure to regulate the storage and transport temperatures of the products manufactured in their Greenville plant, may be significant,” the authors conclude.

“Knowledge of the potential loss of antimicrobial activity of contact lens solutions and other pharmaceutical products when exposed to higher temperatures and the risk of such exposure when storing and transporting those products may help prevent such epidemics in the future.”

Arch Ophthalmol. 2008;126[11]:1493-1498.

Dr. Bullock has served as a consultant for three different law firms concerning the Fusarium keratitis epidemic. The compensation was paid to the Wright State University Foundation and not to Dr. Bullock. No outside funding from any source was provided for this study. Any and all costs associated with this research study were paid for by the authors personally or by CompuNet Clinical Laboratories. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

JAMA and Archives Journals

The following statistics were released today by the Health and Social
Care Information Centre.

Data on written complaints in the NHS, 2004-05

General Ophthalmic Services Statistical Bulletin: Ophthalmic
Statistics for England, 1994-95 to 2004-05

General Ophthalmic Services: Consultation tables, NHS sight tests,
vouchers, workforce, premises, 2004/2005

Links
ic.nhs/pubs/wcomplaints
ic.nhs/pubs/genopthdecade05
ic.nhs/pubs/genopth2005

Help us complete a Work and Well Being Survey that blog is Collaborating in. We are getting no financial remuneration for this project:
Click Here to Go to the Survey

The General Optical Council (GOC) has removed from its registers 464 opticians who failed to renew their registration for 2009-10.

The total removed comprises 183 optometrists, 191 dispensing opticians and 90 bodies corporate. Practitioners are required to renew their GOC registration each year, to stay on the Opticians Registers.

Dian Taylor, GOC registrar and chief executive said: “Registration is critical to public protection, and should not be taken lightly. Clearly, the majority of opticians are aware of the importance of maintaining their registration.

“However, those who have been removed must apply for restoration immediately if they wish to continue working. We have alerted employers, primary care organisations and professional bodies to the list of those registrants who are no longer eligible to practise.”

Individuals who are not registered with the GOC may not practise as dispensing opticians or optometrists in the UK, or use any of the protected titles. Bodies corporate not on the registers may not use or associate any of the protected titles with their company names.

The registration status of an individual or business can be checked on the GOC website, optical

To apply for restoration practitioners must complete an application for restoration form, pay the ??289 restoration fee and provide evidence of having completed the required minimum of Continuing Education and Training (CET) in the past 12 months. Restoration forms are available from the GOC website, or from the registration team on 020 7580 3898 (option 1), email gocoptical

About the General Optical Council

The GOC is the regulator for the optical professions in the UK. Its purpose is to protect the public by promoting high standards of education, performance and conduct amongst opticians. The Council currently registers around 23,500 optometrists, dispensing opticians, student opticians and optical businesses.

Notes

1. These figures do not include 209 opticians who withdrew voluntarily from the registers (for example due to retirement, moving abroad etc).

2. Last year, 442 full registrants were removed for failing to apply for retention.

3. The deadline for receipt of completed retention forms and payments was 15 March 2009.

4. The following are all protected titles under the Opticians Act:

(Registered) optometrist
(Registered) dispensing optician
(Registered) ophthalmic optician
(Registered) optician(s)

5. ‘Practise’ constitutes the undertaking or supervising of functions reserved by the Opticians Act 1989 to registered optometrists and dispensing opticians, such as sight testing, fitting contact lenses and selling particular categories of optical appliances.

6. It is a criminal offence to test sight, fit contact lenses or low vision aids, or dispense to children under 16, while not on the appropriate register. On conviction, a fine of up to ??2,500 for each charge can be imposed. NHS bodies may also refuse payment or reclaim GOS fees in respect of any period during which a practitioner was not registered.

7. To renew their registration, practitioners must provide details of professional indemnity insurance and declarations about health and criminal convictions.

8. To restore to the registers, practitioners must provide evidence of having earned at least 12 general CET points in the 12 months prior to restoration. To restore a specialty, registrants must have gained 12 general CET points AND six specialty CET points in the last 12 months.

Source
General Optical Council

The Wide Angle Mobility Lamp (WAML), a low-vision mobility device used by people experiencing night blindness but few daytime travel problems, provides travel assistance more similar to that of daytime travel than the ITT Night Viewer (ITT), according to a new study.

Researchers conducted engineering evaluations on both devices, including manufacturer’s specifications, ergonomic characteristics, modifications, and pedestrian safety issues.

Twenty-seven patients with retinitis pigmentosa gave rehabilitation evaluations on each device. Investigators found both devices improved nighttime travel for people with night blindness as compared with nighttime travel with no device.

Although some participants preferred the ITT, overall most patients performed better with the WAML.

Journal of Rehabilitation Research & Development – pg 471

About the Journal

JRRD has been a leading research journal in the field of rehabilitation medicine and technology for more than 40 years. JRRD, a peer-reviewed, scientifically indexed journal, publishes original research papers, review articles, as well as clinical and technical commentary from U.S. and international researchers on all rehabilitation research disciplines. JRRD’s mission is to responsibly evaluate and disseminate scientific research findings impacting the rehabilitative healthcare community. For more information about JRRD, visit vard.

Judith LaVoie
judithvard
VA Research Communications Service
vard

There are many potential hazards
for children, teens and adults on Halloween. One of the worst may occur
before the kids knock on any doors and gleefully scream “trick or treat!”

The American Academy of Ophthalmology wants to remind parents this
Halloween that cosmetic contact lenses, like corrective contact lenses, are
medical devices requiring a prescription, and permanent eye damage can
occur if they are improperly used.

“This is an important, yet often overlooked, safety issue,” said
Academy spokesperson Thomas L. Steinemann, MD, an associate professor of
ophthalmology at Case Western Reserve University in Cleveland. “The
consequences can be catastrophic, as improper use can lead to permanent
blindness in the worst cases.”

One year ago, Congress passed a law regulating cosmetic contact lenses.
The law, an amendment to the “Federal Food, Drug and Cosmetic Act,” states
that all contact lenses are considered medical devices, regardless of their
use, including those that are mainly used in costumes or for decorative or
cosmetic reasons.

It also mandates that all contact lenses sold in the United States must
be fit and dispensed by an eye care professional.

Dr. Steinemann, the principal investigator on a study that provided
evidence of dangers caused by improperly dispensed decorative contact
lenses, said many people are still getting them without the required
prescription and do not realize the potential harm they might cause
themselves or their children.

“It’s a year later and most states haven’t followed the lead of the
federal government on this issue,” he said. “If you don’t purchase contacts
from an eye care provider, chances are you are not going to get any
education on how to wear or care for the lens, and most likely you aren’t
getting a proper fit; one size does not fit all. But with proper fitting
and instructions, cosmetic lenses can be worn safely.”

Dr. Steinemann said the law has not yet had a profound effect on
people’s behavior.

“I don’t think many states are moving fast enough to make sure these
sight-threatening devices are properly regulated,” said Dr. Steinemann, who
has treated many emergency cases, including one youth who suffered a
blinding corneal infection following her use of decorative lenses.

“No matter what their purpose, all contact lenses need the same
regulations to help provide the same protection for all wearers,” he said.
“It doesn’t matter why you wear contact lenses — to correct your vision or
just for fun — the risks posed are the same when there is no professional
involvement.”

About the American Academy of Ophthalmology

AAO is the world’s largest association of eye physicians and surgeons
— Eye M.D.s — with more than 27,000 members worldwide. Eye health care is
provided by the three “O’s” — opticians, optometrists and
ophthalmologists. It is the ophthalmologist, or Eye M.D., who can treat it
all: eye diseases and injuries, and perform eye surgery. To find an Eye
M.D. in your area, visit the Academy’s Web site at aao.

American Academy of Ophthalmology

aao

Compared to people with normal vision, those who were blind at birth tend to have excellent memories. Now, a new study reported online in the journal Current Biology, a publication of Cell Press, shows that blind individuals are particular whizzes when it comes to remembering things in the right order.

The findings are a good example of the familiar adage that ‘practice makes perfect’ and reveal that mental capabilities may be refined or adjusted in order to compensate for the lack of a sensory input, according to researchers Noa Raz and Ehud Zohary of Hebrew University.

“Our opinion is that the superior serial memory of the blind is most likely a result of practice,” Zohary said. “In the absence of vision, the world is experienced as a sequence of events. Since the blind constantly use serial-memory strategies in everyday circumstances, they tend to develop superior skills.”

For example, the blind tend to navigate the world by forming ‘route-like’ sequential representations. Blind people also rely on serial-memory strategies to identify otherwise indistinguishable objects, such as different brands of yogurt that vary only in their labeling, the researchers noted. According to their own reports, in order to correctly choose a desired item, the blind typically place objects in a fashioned order and give them ordinal tags, such as ‘the 3rd item on the left.’ Thus, a memory for the order in which items are encountered may be especially important for blind people’s ability to create mental pictures of a scene.

In the new study, the researchers tested the performance of 19 congenitally blind individuals and individually matched sighted controls in two types of memory tasks: item memory and serial memory. In the item-memory tasks, subjects were asked to identify 20 words from a list they heard. In the serial-memory tasks, subjects had to remember not only the words, but also their ordinal position in the list.

Those who were blind recalled more words than the sighted, indicating a better memory overall, they found. Their greatest advantage, however, was the ability to remember longer word sequences according to their original order.

The blind individuals’ remarkable edge in item recall resulted not from a specific advantage in remembering the first words in the list, or the most recent words. Rather, the blind showed a better memory for all of the words, regardless of where they fell. That result suggested that the key to their success may lie in representing item lists as word chains, perhaps by generating associations between adjacent items.

The researchers said they plan to further explore the underlying mental processes responsible for the differences in memory skill by using imaging techniques that measure brain activity.

The researchers include Noa Raz, Ella Striem, Golan Pundak, Tanya Orlov, and Ehud Zohary of Hebrew University in Jerusalem, Israel. This study was funded by the McDonnell Foundation grant #220020046.

Raz et al.: ‘Superior Serial Memory in the Blind: A Case of Cognitive Compensatory Adjustment.’ Publishing in Current Biology 17, 1-5, July 3, 2007. DOI 10.1016/j.cub.2007.05.060. current-biology/

Contact: Erin Doonan

Cell Press

View drug information on ella.

For most people bringing in the New Year means celebrating with friends and family, champagne toasts and cheer, but if you get hit in the eye with a champagne cork, it may mean a trip to the emergency room to try and save your sight.

Jim Doessel knows all too well about the danger a cork can present. He was recently hit in the eye while celebrating his tennis club championship. “I was undoing the cage on the bottle when suddenly the cork shot up and struck me square in the eye,” said Jim. “I crumpled to the ground, stunned by the hit, and my vision was very hazy. Thankfully I’ve regained most of my vision through treatment but my left eye is still very sensitive when transitioning from dark to bright light.”

“A cork can fly up to 50 miles per hour as it leaves the bottle,” said Tamara Fountain, M.D., Jim’s doctor and a clinical correspondent for the American Academy of Ophthalmology. “Warm bottles of champagne and poor technique in removing the cork can result in serious, blinding eye injuries. Anything that travels with such momentum can have a devastating effect if it strikes your eye.”

A few simple steps can eliminate this common holiday injury. “Knowing the right way to open a bottle of champagne will make your holidays enjoyable and safe,” says Dr. Fountain.

“I’m like a backseat driver now around people opening bottles of bubbly,” said Jim, “I’m always telling them how to do it properly. I’ve seen too many injuries over the years, and I know firsthand just how devastating they can be.”

Here are some tips on opening a bottle of champagne properly:

– Make sure sparkling wine is chilled to at least 45 degrees Fahrenheit before opening. The cork of a warm bottle is more likely to pop unexpectedly.

– Don’t shake the bottle. Shaking increases your chances of eye injury.

– To open the bottle safely, hold down the cork with the palm of your hand while removing the wire hood. Point the bottle at a 45-degree angle away from yourself and from any bystanders.

– Place a towel over the entire top of the bottle and grasp the cork.

– Keep the bottle at a 45-degree angle as you slowly and firmly twist the bottle while holding the cork to break the seal. Continue to hold the cork while twisting the bottle. Continue until the cork is almost out of the neck. Counter the force of the cork using slight downward pressure just as the cork breaks free from the bottle.

– Never use a corkscrew to open a bottle of champagne or sparkling wine.

An educational video showing the force of a cork breaking glass, as well as more information about eye safety and eye health, is available at GetEyeSmart.

Broadcast editors: B-roll footage demonstrating how a champagne cork can shatter glass is available.

About the American Academy of Ophthalmology

AAO is the world’s largest association of eye physicians and surgeons-Eye M.D.s – with more than 27,000 members worldwide. Eye health care is provided by the three “O’s” – opticians, optometrists and ophthalmologists. It is the ophthalmologist, or Eye M.D., who can treat it all: eye diseases and injuries, and perform eye surgery.

American Academy of Ophthalmology