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Senior Health Week: Eye Disease
Health News You Can Use •

Latest Eye Disease News:

Implanted Contact Lens Corrects Near- and Far-Sightedness: Surgically implanted under the top surface of the cornea, the lens provides permanent correction of vision problems involving refractive error.

Recent Eye Disease News:

Only One Person in Four Has Even Heard of Ocular Hypertension: A survey finds that only 27 percent of Americans say they have heard of this condition without symptoms that can lead to glaucoma.

Eye Drops Can Help Delay Onset of Primary Open-Angle Glaucoma: Researchers say eye drops used to lower elevated pressure inside the eye are also effective in delaying the onset of primary open-angle glaucoma, a leading cause of blindness.

Guidelines Help You Assess If You Are a Candidate for LASIK Eye Surgery: Patients considering LASIK eye surgery now have an easy way to assess whether they are an good candidate for the procedure.

New Cataract Treatment May Free Patients of Need for Glasses: A new procedure for the treatment of cataracts may allow patients to go without the prescription glasses often needed after the procedure.

Eyes May Provide Early Warning on Stroke: Researchers found that people with impaired mental function were about three times more likely to have abnormalities in the retinal vessels, which are called arterioles.

New Surgical Technique May Offer Alternative for Treating Glaucoma: Israeli researchers say the new, less invasive technique, called enzymatic sclerostomy, uses an enzyme that can be selectively activated on the eye to increase the release of fluid from within the eye.

Vitamin E With Other Supplements Lowers Risk of Macular Degeneration: A Mayo Clinic study says the antioxidant, combined with other vitamins and minerals, may lower the risk of macular degeneration by 25 percent.

Anecortave Acetate May Preserve Vision in Some With Macular Degeneration: Preliminary results from a Phase II clinical trial show that the drug preserves or improves vision in patients with the wet form of age-related macular degeneration.

Drug Lowers Intra-Ocular Pressure in Patients With Open-Angle Glaucoma: Researchers say Xalatan is the only prostaglandin analogue used in the treatment of open-angle glaucoma with five-year effectiveness and safety data.

UV Rays From Summer Sun Can Cause Extensive Eye Damage: Experts recommend sunglasses with 100 percent UV protection to protect against cataracts, macular degeneration, corneal burns, and eye cancer.

Lantanoprost Reported More Effective in Treating Glaucoma: Lantanoprost is more effective than brimonidine in reducing diurnal intraocular pressure in patients with glaucoma, according to European researchers.

Cataracts Leading Cause of Visual Impairment in U.S. Hispanics: Researchers report the incidence of blindness in U.S. Hispanics is now 0.3 percent, a figure considered high for developed countries.

Elderly Women With Cataracts (But Not Men) Have Higher Mortality Rate: Researchers say they have a higher risk of death from cardiovascular, respiratory and other diseases, but not cancer.

Medicare Won't Cover Only Effective Treatment for AMD With Occult Lesions: Health and Human Services denied national coverage of ocular photodynamic therapy (OPT) with verteporfin (Visudyne).

Older Drivers With Cataracts Seen at Much Higher Risk of Auto Accidents: Older drivers with cataracts, even only in one eye, are at increased risk of having a car accident, according to researchers.

Microchips Implanted in Blind May Someday Help Macular Degeneration: Researchers in Illinois have implanted microchips in the eyes of three blind men in a trial that someday may provide help for the 10 million Americans who suffer from macular degeneration and retinitis pigmentosa.

Hormone Replacement Therapy Appears to Reduce Risk of Cataracts: Researchers report that women who take hormone replacement therapy (HRT) after menopause appear to reduce their risks of cataracts.

Eye Disease Primer:

People over the age of 60 are at higher risk of three eye diseases: Age-related macular degeneration, cataracts and glaucoma.

Macular Degeneration: Age-related macular degeneration (AMD) is a common eye disease associated with aging that gradually destroys sharp, central vision. Central vision is needed for seeing objects clearly and for common daily tasks such as reading and driving. In some people, AMD advances so slowly that it will have little effect on their vision as they age. But in others, the disease progresses faster and may lead to a loss of vision in one or both eyes.

The retina is a paper-thin tissue that lines the back of the eye and sends visual signals to the brain. In the middle of the retina is a tiny area called the macula. The macula is made up of millions of light-sensing cells that help to produce central vision. AMD occurs in two forms:

  • Dry AMD--Ninety percent of all people with AMD have this type. Scientists are still not sure what causes dry AMD. Studies suggest that an area of the retina becomes diseased, leading to the slow breakdown of the light-sensing cells in the macula and a gradual loss of central vision.
  • Wet AMD--Although only 10 percent of all people with AMD have this type, it accounts for 90 percent of all blindness from the disease. As dry AMD worsens, new blood vessels may begin to grow and cause "wet" AMD. Because these new blood vessels tend to be very fragile, they will often leak blood and fluid under the macula. This causes rapid damage to the macula that can lead to the loss of central vision in a short period of time.

The greatest risk factor is age. Although AMD may occur during middle age, studies show that people over age 60 are clearly at greater risk than other age groups. For instance, a large study found that people in middle-age have about a 2 percent risk of getting AMD, but this risk increased to nearly 30 percent in those over age 75. Other AMD risk factors include:

  • Gender--Women tend to be at greater risk for AMD than men.
  • Race--Whites are much more likely to lose vision from AMD than Blacks.
  • Smoking--Smoking may increase the risk of AMD.
  • Family History--Those with immediate family members who have AMD are at a higher risk of developing the disease.

Both dry and wet AMD cause no pain. The most common early sign of dry AMD is blurred vision. As fewer cells in the macula are able to function, people will see details less clearly in front of them, such as faces or words in a book. Often this blurred vision will go away in brighter light.

If the loss of these light--sensing cells becomes great, people may see a small--but growing-blind spot in the middle of their field of vision. The classic early symptom of wet AMD is that straight lines appear crooked. This results when fluid from the leaking blood vessels gathers and lifts the macula, distorting vision. A small blind spot may also appear in wet AMD, resulting in loss of one's central vision.

Your eye care professional may suspect AMD if you are over age 60 and have had recent changes in your central vision.

No treatment now exists for dry AMD. It has been suggested that taking certain extra vitamins and minerals may slow the progress of the disease. But this treatment needs much more research before scientists can know for sure if it's helpful. Eye care professionals can treat some cases of wet AMD with laser surgery. This treatment involves aiming a strong light beam onto the new blood vessels to destroy them. Laser surgery is done in a doctor's office or in an eye clinic and lasts a short period of time. Although a person may go home the same day, he or she will need to return for follow-up exams.

Although there is no effective treatment for dry AMD at this time, it is crucial that those who progress to wet AMD and need laser surgery have it before the disease destroys central vision. For this reason, if you have dry AMD or are age 60 or older, you should have your eyes examined through dilated pupils at least once a year.

Cataracts: A cataract is a clouding of the eye's lens that causes loss of vision. The lens lies behind the iris and the pupil. It works much like a camera lens. It focuses light onto the retina at the back of the eye, where an image is recorded. The lens also adjusts the eye's focus, letting us see things clearly both up close and far away. The lens is made of mostly water and protein. The protein is arranged in a precise way that keeps the lens clear and lets light pass through it.

But as we age, some of the protein may clump together and start to cloud a small area of the lens. This is a cataract. Over time, the cataract may grow larger and cloud more of the lens, making it harder to see.

Researchers suspect that there are several causes of cataract, such as smoking and diabetes. Or, it may be that the protein in the lens just changes from the wear and tear it takes over the years.

You don't have to be a senior citizen to get this type of cataract. In fact, people can have an age-related cataract in their 40s and 50s. But during middle age, most cataracts are small and do not affect vision. It is after age 60 that most cataracts steal vision.

A cataract starts out small. It has little effect on vision at first. You may notice that your vision is blurred a little, like looking through a cloudy piece of glass. A cataract may make light from the sun or a lamp seem too bright, causing a glare. Or, you may notice when you drive at night that the oncoming headlights cause more glare than before. Also, colors may not appear as bright to you as they once did.

As the cataract gets bigger and clouds more of the lens (doctors use the term, "ripens"), you will find it harder to read and do other normal tasks. The word "cataract" means waterfall. For people with a ripe cataract, it is like trying to see through a waterfall.

Although you might think you have a cataract, the only way to know for sure is by having an eye examination. Should your eye care professional find one, he or she can monitor it and advise you about any future treatment.

If your eye care professional finds a cataract, you may not need cataract surgery for several years. In fact, you might never need cataract surgery. By having your vision tested regularly, you and your eye care professional can discuss if and when you might need treatment.

Cataract surgery is very successful in restoring vision. In fact, it is one of the most common surgeries performed in the United States, with over 1.5 million cataract surgeries done each year. Your eye care professional will remove your clouded lens and, in most cases, replace it with a clear, plastic lens.

The National Eye Institute (NEI), one of the Federal government's National Institutes of Health, supports research on the lens and age-related cataract. Most of these studies focus on controlling cataract with drugs so that surgery will not be needed. Although these drugs are not yet available to patients, research is moving forward in this area. The NEI is also evaluating whether certain vitamins and minerals might prevent or slow the progress of cataract. We should know more about whether this treatment works in the coming years.

If you are over age 60, you should have an eye examination at least once every two years. This exam should include dilating your pupils. This means drops are put into your eyes to enlarge your pupils. Although a cataract can be detected without dilated pupils, your eye care professional can see the back of your eye better using this exam.

Glaucoma. Glaucoma is an eye disease in which the normal fluid pressure inside the eyes slowly rises, leading to vision loss--or even blindness. At the front of the eye, there is a small space called the anterior chamber. Clear fluid flows in and out of the chamber to bathe and nourish nearby tissues. In glaucoma, for still unknown reasons, the fluid drains too slowly out of the eye. As the fluid builds up, the pressure inside the eye rises. Unless this pressure is controlled, it may cause damage to the optic nerve and other parts of the eye and loss of vision.

Nearly 3 million people have glaucoma, a leading cause of blindness in the United States. Although anyone can get glaucoma, some people are at higher risk. They include:

  • Blacks over age 40.
  • Everyone over age 60.
  • People with a family history of glaucoma.

At first, there are no symptoms. Vision stays normal, and there is no pain. However, as the disease progresses, a person with glaucoma may notice his or her side vision gradually failing. That is, objects in front may still be seen clearly, but objects to the side may be missed. As the disease worsens, the field of vision narrows and blindness results.

Many people may know of the "air puff" test or other tests used to measure eye pressure in an eye examination. But, this test alone cannot detect glaucoma. Glaucoma is found most often during an eye examination through dilated pupils. This means drops are put into the eyes during the exam to enlarge the pupils. This allows the eye care professional to see more of the inside of the eye to check for signs of glaucoma.

Although open-angle glaucoma cannot be cured, it can usually be controlled. The most common treatments are:

  • Medications: These may be either in the form of eye drops or pills. Some drugs are designed to reduce pressure by slowing the flow of fluid into the eye. Others help to improve fluid drainage. For most people with glaucoma, regular use of medications will control the increased fluid pressure. But, these drugs may stop working over time. Or, they may cause side effects. If a problem occurs, the eye care professional may select other drugs, change the dose, or suggest other ways to deal with the problem.
  • Laser surgery: During laser surgery, a strong beam of light is focused on the part of the anterior chamber where the fluid leaves the eye. This results in a series of small changes, which makes it easier for fluid to exit the eye. Over time, the effect of laser surgery may wear off. Patients who have this form of surgery may need to keep taking glaucoma drugs.
  • Surgery: Surgery can also help fluid escape from the eye and thereby reduce the pressure. However, surgery is usually reserved for patients whose pressure cannot be controlled with eye drops, pills, or laser surgery.

Studies have shown that the early detection and treatment of glaucoma, before it causes major vision loss, is the best way to control the disease. So, if you fall into one of the high-risk groups for the disease, make sure to have your eyes examined through dilated pupils every two years by an eye care professional.

Background information provided by: The National Eye Institute, National Institutes of Health, Bethesda, MD 20892

























































































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