Eye Care Medical Blog

It will be harder to lie about your age or your poker hand after new research by the University of Melbourne, Australia has revealed that our eye position betrays the numbers we are thinking about.

In the study, participants were asked to state a series of random numbers. By measuring their vertical and horizontal eye position, researchers were able to predict with reliable confidence the next chosen number – before it was spoken.

Specifically, a leftward and downward change in eye position announced that the next number would be smaller than the last. Correspondingly, if the eyes changed position to the right and upward, it forecast that the next number would be larger. The degree of eye movement reflected the size of the numerical shift.

The paper was published online in the prestigious journal Current Biology.

First author, Dr Tobias Loetscher of the University of Melbourne’s School of Behavioural Sciences and previously of the Department of Neurology, University Hospital Zurich, Switzerland says the research demonstrates how the eyes and their position give insight into the nature of the systematic choices made by the brain’s random number generator.

“When we think of numbers we automatically code them in space, with smaller number falling to the left and larger numbers to the right. That is, we think of them along a left-to-right oriented mental number line – often without even noticing this number-space association ourselves.”

“This study shows that shifts along the mental number line are accompanied by systematic eye movements. We suggest that when we navigate through mental representations – as for example numbers – we re-use brain processes that primarily evolved for interacting and navigating in the outside world.”

Dr Michael Nicholls also of the School of Behavioural Sciences adds, “Clearly, the eyes not only allow us to see the world around us, but they also present a window to the working of our mind, as this study shows.”

“This study will hopefully provide a template to investigate how the human mind works via a connection with the space and world around us,” he says.

The study involved asking twelve right-handed men to select from a set of random numbers. Paced by an electronic metronome they named 40 numbers between 1 and 30 in a sequence as random as possible. For each number, the researchers measured the average eye position during the 500 millisecond interval before the numbers were stated.

Source:
Rebecca Scott

University of Melbourne

For twelve years, experts from different disciplines in the fields of microelectronics, neurophysics, information engineering, computer science, materials science and medicine have been working to develop a visual prosthetic device for patients who have lost their sight through diseases of the retina. In September 2007, their effort was rewarded. In a clinical study including six patients, the team was able to demonstrate not only that a completely implantable vision prosthesis is technically feasible and proven functioning, but also that it enables patients to perceive visual images. “For normally sighted people that may not seem much, but for the Blind, it is a major step,” comments Dr. Hoc Khiem Trieu from the Fraunhofer Institute for Microelectronic Circuits and Systems IMS in Duisburg. “After years of blindness, the patients were able to see spots of light or geometric patterns, depending on how the nerve cells were stimulated.” Dr. Hoc Khiem Trieu has been involved from the outset of this project, which was funded by the German Ministry of Education and Research. Together with Dr. Ingo Krisch and Dipl.-Ing. Michael G?�rtz he translated the specifications given by the medical experts and material scientists into an implant and chip design. The scientists are to receive the Joseph von Fraunhofer Prize 2008 for their work.

“A milestone was reached when the prosthetic system finally operated wirelessly and remotely controlled,” explains Dr. Ingo Krisch. “A great deal of detailed work was necessary before the implant could be activated without any external cable connections.” “The designs became smaller and smaller, the materials more flexible, more robust and higher in performance, so that the implant now fits comfortably in the eye,” reports Michael G?�rtz. The system benefits from a particular disease pattern, and it uses a specific operating principle to restore sight: Suffering from retinitis pigmentosa, the light sensitive cells are destroyed, but the connection of the nerve cells to the brain remains intact. The scientists have bypassed the defects of the retina by means of a visual prosthesis. The complete system comprises the implant and an external transmitter integrated in a spectacle-frame. The implant system converts the image patterns into interpretable stimulation signals. Data and energy are transferred to the implant by a telemetric link. The nerve cells inside the eye are then stimulatedaccording to the captured images. Those intact cells are innervated by means of three-dimensional stimulation electrodes that rest against the retina like small studs.

EPI-RET GmbH, a spin-off of this project consortium, intends to market the vision prosthesis in about three years’ time after a new clinical study of selected patients has been completed with the final product.

This release is available in German.

Source: Dr. Ingo Krisch

Fraunhofer-Gesellschaft

Richard L. Abbott, MD became the new president of the American Academy of Ophthalmology on January 1, 2011, taking over from departing President Randy Johnston, MD. Dr. Abbott currently serves as the Thomas W. Boyden health sciences clinical professor of ophthalmology at the University of California, San Francisco and research associate at the Francis I. Proctor Foundation.

“Ophthalmology is flourishing, and we are facing more opportunities and challenges than ever before,” said Dr. Abbott. “I look forward to working on issues that are important to our members now and to inspire them to become future leaders for our profession.”

Dr. Abbott has held numerous leadership positions in the Academy. He most recently was a member of the Academy’s Committee of Secretaries, holding the position of secretary for quality care and knowledge base development from 2002 to 2008. He has served in several leadership positions since 1981, including secretary for quality of care (1994) and a member of the Academy’s Board of Trustees as senior secretary for ophthalmic practice (1996 to 2001). In 2009 and 2010, he served as chairman of the board of OMIC (Ophthalmic Mutual Insurance Company). In 2006, Dr Abbott received the Academy’s Lifetime Achievement Award and in 2008 he was elected into Academia Ophthalmologica Internationalis.

“We are pleased to have Dr. Abbott provide his leadership throughout 2011,” said David W. Parke II, MD, CEO of the Academy. “In addition to his recognized clinical and academic expertise, Dr. Abbott possesses special interest in international ophthalmology and in the quality of care arena.”

Dr. Abbott received his medical doctorate in 1971 from the George Washington University School of Medicine. After completing his internship at Los Angeles County Hospital, he spent two years in the Indian Public Health Service teaching medics and running a community health clinic on the Navajo reservation. He completed his fellowship in corneal and external diseases at the Bascom Palmer Eye Institute in Miami.

Source:

American Academy of Ophthalmology

This month’s Ophthalmology, the journal of the American Academy of Ophthalmology, includes new studies on links between eye diseases and two widely-prescribed drugs: SSRI (selective serotonin reuptake inhibitor) antidepressants, and amantadine, a Parkinson’s disease treatment.

Some Antidepressants May Bump Up Cataract Risk

Seniors who take SSRI antidepressants may be more likely to develop cataracts , says the first major study to examine this interaction. The risk appears to increase by about 15 percent, which in the United States would translate to 22,000 cataract cases attributable to antidepressant use. The study, led by Mahyar Etminan, PharmD, of Vancouver Coastal Health Research Institute, Canada, assessed data for nearly 19,000 people age 65 or older, all of whom also had cardiovascular disease. Their records were compared to about 190,000 controls.

The effect was strongest for three SSRIs: Luvox (fluvoxamine) increased risk by 39 percent, Effexor (venlafaxine) by 33 percent and Paxil (paroxetine) by 23 percent. The apparent increased risk was associated only with current, not past, drug use. Some antidepressants did not appear to be associated with cataract risk, but this could have been because the numbers of study participants using these drug types were too small to show effects, or because only specific agents in certain medications are related to cataract formation. These questions need further study.

“The eye’s lens has serotonin receptors, and animal studies have shown that excess serotonin can make the lens opaque and lead to cataract formation,” Dr. Etminan said. “If our findings are confirmed in future studies, doctors and patients should consider cataract risk when prescribing some SSRIs for seniors,” he added.

Earlier research linked beta blocker medications and oral and inhaled steroids to higher cataract risk, and a recent Swedish study suggests that women’s hormone replacement therapy may also raise risk.

Long-term Use of Parkinson’s Drug May Impact Vision

Parkinson’s disease, the second most common neurodegenerative disease after Alzheimer’s, is often treated with amantadine. The drug helps alleviate patients’ motor problems and may be taken for years. Doctors have long known that amantadine treatment causes abnormal changes in the cornea in some Parkinson’s patients. The cornea is the eye’s clear outer surface that provides most of the visual power. Usually corneal reactions occur soon after starting the drug and disappear a few weeks after it is withdrawn. But sometimes corneal disorders appear only after years of treatment, and the corneas of these patients often do not recover when amantadine is stopped. Won Ryang Wee, MD, PhD, and his colleagues at Seoul National University College of Medicine, South Korea, studied whether the effect of amantadine on corneal endothelial cells is dependent on the cumulative dose received.

The researchers compared 169 eyes of amantadine-treated patients with an equal number of matched controls; the average age of all subjects was 59. They found that the patient group with the highest cumulative amantadine intake and/or longest duration of treatment (up to 8 years) had the most significant reductions in endothelial cell density (ECD). Endothelial cells work to keep excess water out of the main body of the cornea. When there are too few endothelial cells, corneal edema (swelling) results and vision is impaired. This study noted two early indicators of abnormal corneal changes in response to amantadine, before ECD reduction occurred: deformation of the normal hexagonal cell shape, and increase in cell size variation. The findings also show that ECD reduction in response to amantadine treatment does not occur quickly.

“Assuming other studies confirm these results, ophthalmologists and neurologists should consider evaluating a patient’s corneal endothelium at the beginning of treatment with amantadine and reassess at regular intervals if the drug is used long term,” Dr. Wee said, “and additional monitoring would be needed for patients with other conditions that reduce ECD-such as recent cataract surgery or ongoing glaucoma, uveitis or Fuch’s dystrophy-because corneal edema could develop during treatment.”

Source
American Academy of Ophthalmology

View drug information on Effexor; LUVOX; Paxil CR.

Both Type 1 and 2 diabetes are on the rise nationally, and in Minnesota, one in four either have diabetes or are at risk of developing it, compared to one in five in 2006. According to the Minnesota Department of Health, diabetes is the leading cause of blindness among Minnesotans age 20-74. Between 500 and 800 Minnesotans become blind annually due to complications of this disease.

Diabetic retinopathy is the most common eye disease associated with diabetes. According to the Minnesota Optometric Association (MOA), early treatment of retinopathy reduces the incidence of severe vision loss by 50-60 percent.

“November is Diabetes Month, a good time to raise awareness of diabetes-related eye heath,” said Dr. Tina McCarty, President of the Minnesota Optometric Association (MOA) Board of Trustees, and an optometrist practicing at the Eye Care Center, with offices in Fridley and Maplewood, Minnesota. “Diabetes can be managed through an integrated health management program that includes comprehensive eye exams annually. People may not realize that diabetes can also cause vision changes that require regular exams,” Dr. McCarty added.

An estimated 60 percent of those with Type 1 diabetes for 10 years will have some signs of retinopathy, and after 15 years, virtually all Type 1 diabetic patients will have retinopathy. The first stages of retinopathy may not be discernable to the patient, but early detection and treatment is vital to prevent vision loss. Cataracts and glaucoma are also more common among diabetics.

Diabetic retinopathy is caused by changes in the blood vessels of the retina. In some people with diabetic retinopathy, retinal blood vessels may swell and leak fluid; in others, abnormal new blood vessels grow on the surface of the retina. These changes may result in vision loss or blindness.

Diabetic retinopathy also should be managed by taking prescribed medications as instructed, staying with a healthy diet, exercising regularly, controlling high blood pressure and blood sugars and avoiding alcohol and smoking.

The Minnesota Optometric Association (MOA) recommends you see your family eye doctor right way if you have any of the following problems:

– Your vision is blurry
– You see double, spots or floaters
– One or both eyes hurt
– You feel pressure in your eye
– You can’t see things at the periphery as well as before
– You have trouble reading

The Minnesota Optometric Association has 525 member doctors of optometry around the state. The MOA is committed to furthering awareness of optometrists as primary eye care or family eye doctors and to bringing about change that positively impacts the MOA member doctors and their patients.

minnesotaoptometrists

The Glaucoma Research Foundation announced that Adrienne L. Graves, PhD has been appointed to its Board of Directors.

Dr. Graves is President and CEO of Santen Inc., a wholly owned subsidiary of Japan’s Santen Pharmaceutical Co., Ltd. (Tokyo Stock Exchange: 4536).

Kuldev Singh, MD, MPH, Board Chair of the Glaucoma Research Foundation and Director of Glaucoma Service and Professor of Ophthalmology at Stanford University, commented, “Having observed the quality of Dr. Graves’ work as a scientist and CEO, I feel she brings tremendous energy, experience and qualifications to the board.”

Thomas M. Brunner, President and CEO of the Glaucoma Research Foundation, added, “The addition of Adrienne Graves will bring a desired and positive skill set and dynamic to our board. We’re proud to have her join what is already a varied and high quality group of medical specialists and professionals.”

Dr. Graves was trained as a visual scientist before beginning her career in the ophthalmic pharmaceutical industry. She studied visual psychophysics and electrophysiology at Brown University, University of Michigan, and University of Paris before joining Alcon Labs. Dr Graves spent 9 years at Alcon before joining Santen in 1995 to help found their U.S. operations.

In addition to her role as President and CEO of Santen Incorporated, she serves as a corporate officer for Santen Pharmaceutical Co., Ltd., and serves on the board of directors for TearLab Corporation. She also serves on the boards of the AAO (American Academy of Ophthalmology) Foundation, the Pan-American Ophthalmological Foundation, and the Corporation Committee for the Brown University Medical School. She co-founded OWL (Ophthalmic Women Leaders) with Dr. Marguerite McDonald.

Source
Glaucoma Research Foundation
Santen Inc.

A new study by researchers at Harvard Medical School has found that combining essential B vitamins, including B6, B12, and folic acid, lower risk of developing age-related macular degeneration (AMD), one of the leading causes of vision loss among older Americans. These ingredients, which are formulated in combination with key omega-3 fatty acids and phytosterols, are also contained in the prescription supplement Animi-3, which is actively being prescribed by physicians to address deficiencies in these nutrients.

In the randomized, double-blind clinical trial, more than 5,000 women with heart disease, and at least three risk factors for cardiovascular disease, were given vitamins B6, B12, and folic acid over a seven-year time period. At the end of the trial, approximately 34 percent of the women had a lower risk of developing any type of AMD, while 41 percent had a lower risk of more severe forms of AMD.

“What’s interesting here is the study authors note the correlation between age-related macular degeneration and cardiovascular disease,” said nutritional expert Dr. Barbara Levine, Weill Cornell Medical College. “I recommend patients with nutritional deficiencies speak to their physicians about Animi-3, which is formulated with these essential B vitamins and DHA, the most important omega-3 fat, to address various conditions, including heart disease, arthritis, eye health, and depression.”

“DHA is highly concentrated in the retina of the eye, which is one of the reasons why a DHA deficiency may be important to vision,” added President Jack Schramm, PBM Pharmaceuticals, Inc., the makers of Animi-3. “Animi-3 delivers DHA as well as B6, B12, and folic acid. Studies continue to suggest that DHA, along with a combination of vitamins B6, B12, and folic acid, can address deficiencies in these nutrients associated with eye problems, including dry eye and macular health.”

Each capsule of Animi-3 contains 500 mg of omega-3, (350 mg of DHA), 200 mg of phytosterols, 1 mg of folic acid, 12.5 mg of B6, and 12 mcg of B12.

More information on Animi-3 ingredients is found on animi-3 and on dhaandbvitamins, a resource developed by specialists at Weill Cornell Medical College and other leading medical centers.

Animi-3 is not intended to diagnose, treat, or cure any disease.

Article Source: cnn/2009/HEALTH/02/24/macular.degeneration.vitamins/index.html

PBM Pharmaceuticals, Inc.
pbmpharmaceuticals

White Paper – governance debate

At its November meeting of Council, members debated proposals for implementing some of the recommendations outlined in the Government White Paper on healthcare regulation. From November 2008 it will be a statutory obligation to use the civil standard of proof in all Fitness to Practise hearings. GOC hearings currently use the criminal standard of proof, and Council discussed a timeframe for the change over. The White Paper also recommends that Council should become smaller and more board-like and that all members should be appointed according to specified criteria and competencies. Council decided in March that it should reduce its size to no larger than 13 members. Possible skills and competencies for appointed members were considered, along with proposals for a stakeholder engagement strategy.

Therapeutic prescribing – changes to the Registration Rules

This summer the Department of Health announced that optometrists will be able to train to prescribe medicines independently. The decision will enable practitioners to prescribe licensed medicines for ocular conditions affecting the eye and surrounding tissue. Changes to existing legislation are expected to pass through Parliament during spring 2008, and Council discussed changes to the Registration Rules that will create an Independent Prescribing specialty.
Registrants wishing to become independent prescribers will have to complete GOC-approved training. Once their training is completed, they must apply to have the specialty entered against their name in the register. Specialty practitioners will have to keep their skills up to date by completing additional CET. The GOC could approve training courses in time to enable recruitment of the first trainees next autumn.

Sale and supply new guidance

Further revisions have been made to professional guidance on the sale and supply of optical appliances. The guidance is issued by the College of Optometrists and ABDO. Legal opinion has been sought to ensure the guidance accurately reflects the law. The Standards Committee reviewed the amended guidance, which was then considered by Council.

Budgets: revised 2007/8 and outline for 2008/9

A revised budget for this financial year anticipates an increased income. This is a result of cautious forecasting, particularly for retention income at the end of the first CET cycle. Costs attributed to implementing the White Paper have been less than expected, due to delays in the legislative timetable. Council approved the draft budget for 2008/9, which is based on the current registration fee of ??169. A deficit budget is forecast for reasons that include; increased spending on White Paper implementation and; changes following the EU Directive on temporary and occasional registration.

Registration fees 2008/9

There will be no increase to the GOC full registration fee for 2008/9. Members agreed the fee at the November meeting of Council. Full registrants will continue to pay ??169 for registration or retention. Student registration will stay at ??20, and restoration ??239.The registration fee is currently made up of three components; the core fee, CET levy and Consumer Complaints Mediation Service (CCMS) levy. As CET is a core element of the GOC’s work, the CET levy and core registration fee will in future be amalgamated into one component. The CCMS levy will remain a ‘stand alone’ component of the overall fee.

Equality and Diversity Scheme

Members approved the Council’s Equality and Diversity scheme. The main objective of the scheme is to ensure the following areas of the Council’s business remain free from discrimination: access to optometry and dispensing optics training; registration as an optometrist or dispensing optician; access to the registers and other public meetings and information; complaints and Fitness to Practise processes, and; employment with or appointment to the GOC. An accompanying action plan establishes the GOC’s priorities for the next three years, which includes collecting data from current registrants.

CET – 2010 and beyond

Next month the GOC is set to launch a CET consultation to consider ideas for changes to the next CET cycle, beginning 1 January 2010. At the November meeting of Council, members discussed new and existing principles of the CET scheme that will be included in the consultation. Areas of discussion included a ‘rolling’ three year cycle, and the possibility of introducing different points requirements for optometrists and dispensing opticians, to reflect different levels of risk. Other possible questions for consultation are: whether registrants should be required to gain points across a spread of competency areas; and whether there should be a restriction on the number of points gained through distance learning. Further details of the consultation will published on the GOC website in the next few weeks.

Committee membership 2008

Council bade a formal farewell to three long-standing members. Roger Buckley, Bob Chappell and James Dunne all retire from Council at the end of the year, having served for more than 50 years between them. Roger Buckley was appointed to the GOC in 1988, and has chaired the Standards Committee since its creation in 1999. Bob Chappell has served on a number of committees since he joined the GOC in 1983. James Dunne has sat as ophthalmologist representative on the Investigation Committee for a decade. They will be replaced by Rob Hogan, appointed by the College of Optometrists, and Nigel Andrews and Ahmed Sadiq, both appointed by the Royal College of Ophthalmologists.

European Directive – temporary and occasional registration

On 20 October 2007, new EU legislation came into force designed to make it easier for qualified professionals to move around Europe. The European Directive on the recognition of professional qualifications means that health care professionals, including optometrists and dispensing opticians, can register to work in other European countries on a temporary and occasional basis. GOC registrants can apply to provide services on a temporary and occasional basis by contacting the equivalent regulatory body in that country. They may be required to fill in a declaration, and provide supporting documents including evidence of indemnity insurance. Anyone using the titles “optometrist” or “dispensing optician” who wishes to practise in the UK on an occasional or temporary basis, will have to be registered with the GOC. They will be assessed on competencies, qualifications and experience, and may be asked to complete an aptitude test.

General Optical Council

All our daily activities, from driving to work to solving a crossword puzzle, depend on signals carried along the body’s vast network of neurons. Propagation of these signals is, in turn, dependent on myriad small molecules within nerve cells – receptors, ion channels, and transmitters – turning on and off in complex cascades. Until recently, the study of these molecules in real time has not been possible, but researchers at the University of California at Berkeley and the University of Munich have attached light-sensing modules to neuronal molecules, resulting in molecules that can be turned on and off with simple flashes of light.

“We get millisecond accuracy,” says Joshua Levitz, a graduate student at Berkeley and first author of the study. According to Levitz, the “biggest advantage is that we can probe specific receptors in living organisms.” Previous methods using pharmacological agents were much less specific, affecting every receptor in every cell. Now, investigators can select individual cells for activation by focusing light. And by attaching light-sensing modules to one class of molecules at a time, they can parse the contributions of individual classes to neuronal behavior.

Levitz presented a system in which G-protein-coupled receptors, molecules that play key roles in transmitting signals within cells, can be selectively activated. He is planning to use the system to study the hippocampus, a region of the brain where memories are formed, stored and maintained. There may be clinical utility to the system as well, he points out. G-protein-coupled receptors are also critical for vision in the retina, and light-sensing versions could potentially be introduced into people with damaged retinas in order to restore sight.

Notes:

The presentation, “Design and Application of a Light-Activated Metabotropic Glutamate Receptor for Optical Control of Intracellular Signaling Pathways” was presented at the Baltimore Convention Center.

The research was funded by the Nanomedicine Development Center at the National Institutes of Health.

Source:
Ellen R. Weiss
American Institute of Physics

Researchers in Illinois and Singapore have found that the aging brain reflects cultural differences in the way that it processes visual information. This study appears this month in the journal Cognitive, Affective & Behavioral Neuroscience. This paper and another published by the same group in 2006 are the first to demonstrate that culture can alter the brain’s perceptive mechanisms.

The new finding is the result of a collaboration between University of Illiniois psychology professor Denise Park and Michael W. Chee, of the Cognitive Neuroscience Laboratory, SingHealth, in Singapore. Park, Chee and their colleagues conducted an array of cognitive tests on study subjects at their facilities in the U.S. and Singapore, and used identical functional Magnetic Resonance Imaging (fMRI) scanners at both sites. Their analysis, of 37 young and old East Asians, and 38 young and old Westerners, found significant cultural differences in how the older adults’ brains responded to visual stimuli.

“These are the first studies to show that culture is sculpting the brain,” said Park, principal investigator on the study. “The effect is seen not so much in structural changes, but at the level of perception.”

Park also will present these findings at the May 2007 meeting of the Association for Psychological Science in Washington, D.C.

Scientists have known for decades that East Asians and Westerners process visual information differently. An analysis published in 1972 noted that East Asians are more likely to pay attention to the context and relationships in a picture than are Westerners, who more often notice physical features or groupings of similar subjects.

More recent research, which analyzed the eye movements of East Asians and Westerners viewing identical images, found that Westerners were more attentive to central, or dominant, objects, while East Asians paid more attention to the background, or scene.

The use of fMRI technology allowed the researchers to determine which brain regions were activated when study subjects contemplated various images.

A 2006 analysis published by Park, Illinois postdoctoral fellow Angela Gutchess and colleagues at the University of Michigan reported differing neural activation patterns in the brains of East Asians and Americans shown identical pictures. The Americans showed more activity in brain regions associated with object processing than the East Asians, whose brains showed more activity in areas involved in processing background information.

The most recent study takes this work further, comparing neural responses to visual stimuli in young and old adults in both cultures. In this analysis, the researchers found equivalence between all four groups (young and old East Asians; young and old Americans) in terms of how they processed background information in the parahippocampal gyrus, a brain region vital to memory encoding and retrieval. As expected, older adults in both cultures exhibited diminished binding processes (the ability to connect a particular object to its background) in the hippocampus, as compared with younger study subjects. The older subjects also exhibited diminished object processing in the lateral occipital complex.

The most striking finding was that the object areas of the older East Asian subjects responded much more weakly to novel stimuli (that is, the appearance of new objects in the pictures) than did those same brain regions in the older Americans. For the older East Asians, a lifetime of enhanced attention to the backgrounds, or context, of pictures eventually showed up as a diminished response in the part of the brain that keeps track of foreground objects.

“These findings demonstrate the malleability of perceptual processes as a result of differences in cultural exposure over time,” the researchers wrote.

Contact: Diana Yates

University of Illinois at Urbana-Champaign