A Pocket-Sized Revolution in Eye Care

A pocket-sized device made with spare parts of phones and computers ordered online for under $200 could hold the future of eye care.

According to a recently published article in NBCNews, the device acts essentially as a retina camera with the ability to take images of the inside of an eye.

A pair of the researchers responsible for this advancement, Dr. Shizuo Mukai and Dr. Bailey Shen, are claiming that this technology can hopefully soon replace eyecare practices of late where patients are subjected to strong eye drops to dilate the eye in order for an ophthalmologist to be able to properly examine the health of the eyes. The new device will cut the eye drops from current practice and simply use infrared light focused on the back of the eye to snap an image of the entire eye without the pupil constricting.

However, before excitement takes hold that this product may soon be on the market, there is still a lot of work to be done. In fact, Dr. Mukai, an ophthalmology professor at Harvard, and Dr. Shen, an ophthalmologist with UIC College of Medicine, are making the prototype available to tech experts and doctors for further testing and design insight. By doing this, the researchers behind this new device hope to gain more sophisticated software to improve the images taken by the retina camera, which will ultimately lead to stronger diagnoses.

The most exciting aspect of this device is the possibilities it brings. For one, the prototype cost only $185, and was constructed from a combination of cellphone parts, LED lights, and pieces from a computer kit. Once a scalable model is created, prospects are high that this device could be mass produced at a low rate, making it more accessible globally as well. Aside from relieving the pain and inconvenience of eyedrops, Dr. Rahul Khurana, the clinical spokesperson for the American Academy of Ophthalmology, has hopes that this technology can be used in poorer countries where access to healthcare is not as prevalent.

Because the device doesn’t require the eye to be dilated, patients who are unable to have their eyes dilated will be able to be screened for eye health concerns that were not able to be examined before. As Dr. Shen stated in a Harvard Medical School article on the findings, “…As residents seeing patients in the hospital, there are often times when we are not allowed to dilate patients–neurosurgery patients for example.” With its convenient and portable size, Dr. Shen hopes the device can be used to cut down on the amount of time it can take to give an eye exam, especially in hospitals, stating, “…there are times when we find something abnormal in the back of the eye, but it is not practical to wheel the patient all the way over to the outpatient eye clinic just for a photograph.”

By making eyecare more accessible, the possibilities of mastering eye health throughout the world become more attainable. While this prototype is not the first to make a breakthrough on retina camera technology, it does offer a wider spectrum of vision in the lense for clearer and more precise imaging. The development of these discoveries can only grow from here, giving researchers in ophthalmology something very special to look forward to–soon, they hope, with perfect vision.

Could 3-D Retina Transplants Put a Stop to Degenerative Blindness?

More than two million Americans suffer from age-related macular degeneration (AMD). While AMD does not result in total blindness, it is the leading cause of vision loss among Americans age 50 and above, and it causes sufferers to slowly lose central vision and interferes with an individual’s ability to drive, read, write, recognize faces, and more. There is no cure for AMD, although doctors can prescribe treatments in an effort to slow its progression.

AMD is only one of several degenerative eye conditions that lead to vision loss for which there has been no cure since it is caused by the actual decay of structures within the eye. However, this may soon change thanks to a groundbreaking advance in medicine: the development of transplantable 3-D retinas.

A team of researchers at California-based AIVITA Biomedical led by CEO Hans Keirstead, PhD have successfully used human embryonic stem cells (hESCs) to develop a 3-D “retinal organoid” made of laminated retinal progenitor cells and retinal pigment epithelium (RPE). In preclinical studies, the researchers showed that, when injected into the eye, the organoid was able to form synaptic connections with existing tissue and thus restore vision.

“The cause for hope for transplanting a 3-D retina has never been greater,” Keirstead told Modern Retina. “We have been on a relatively long journey, but are now at a point where we will be walking along a well-articulated path that will lead us to the beginning of our first in-human study.”

Keirstead, who suspects that a clinical research phase for the 3-D retinas may be as soon as two years away, explained that AIVITA’s target population is patients with degenerative disease of the outer retina, like AMD or retinitis pigmentosa. The 3-D retinas can be transplanted in the patient’s eye to replace the diseased or non-functional photoreceptors and RPE and establish new, functional connections with the inner retina and restore lost vision.

Of course, there are still a number of challenges ahead of the researchers, and the retinas are still years away from becoming commercially available for patients. But the possibility that 3-D retinas could be viable for use in patients opens the door for millions of patients, potentially, to get their sight back.

Are Eye Transplants on the Horizon?

The human body is incredibly resilient, and even after parts of it have been destroyed, it can accept foreign tissue via transplants–in certain circumstances–and continue to function as if nothing ever happened. Doctors today can transplant organs such as hearts, lungs, kidneys, and others from one person to another; there’s even a doctor who wants to perform a head transplant by next year. One organ that still cannot be transplanted is the eye, but thanks to a team of doctors and researchers in Pittsburgh, Pennsylvania, that may not be the case for very long.

Dr. Kia Washington, a plastic surgeon at the University of Pittsburgh Medical Center, is leading a research team with the goal of performing the first successful human eye transplant. She hopes that the procedure will be ready within the next 10 years.

In the United States, over one million people have vision impairments as a result of injuries. In fact, traumatic eye injuries are the fourth most common cause of combat injuries for American soldiers, which is why the Department of Defense is sponsoring Washington’s research: If she discovers a procedure for eye transplants, then it will go a long way toward treating soldiers, as well as the thousands of civilians who have impaired vision or no vision at all due to injuries.

Of course, this is all much easier said than done. A successful eye transplant would require, for one, a way of keeping the optic nerve alive during the procedure and reattaching it to the new host’s brain. Normally, upon removal, the cells in the optic nerve die immediately, thus rendering the eye useless; even if they didn’t, the new optic nerve would need to grow from the eye all the way back to the brain, which is no small feat.

However, one of Washington’s colleagues recently published a paper indicating that a cocktail of drugs, including the multiple sclerosis drug 4-AP, could help blind mice regrow their optic nerves and regain their sight after injury. This procedure, if replicable in humans, could lead to successful eye transplants. Although it is a “moonshot,” transplanting eyes in the next 10 years would be an incredible achievement that would help to treat cases of injury-related vision loss.

Keratoconus and New Stem Cell Research

Did you know the cornea is the only living tissue that has no direct or indirect connection to blood vessels to obtain the oxygen and nutrients it needs to remain healthy? Instead, it absorbs oxygen from the outside air (diffused through the tears) and it gains nutrients from the inside using the aqueous humor (fluid that fills the chamber behind it).

According to WebMD, we see through the cornea, which can be described as the clear outer lens or “windshield” of the eye. Normally, the cornea has a dome shape, like a ball. Sometimes, however, the structure of the cornea is just not strong enough to hold this round shape and the cornea bulges outward like a cone. This condition is called keratoconus.

Keratoconus is a progressive non-inflammatory disorder that causes a characteristic thinning and cone-like steepening of the cornea. According to WebMD, it is caused by a decrease in protective antioxidants in the cornea. The cornea cells produce damaging by-products, like exhaust from a car. Normally, antioxidants get rid of them and protect the collagen fibers. If antioxidants levels are low, the collagen weakens and the cornea bulges out.

How is Keratoconus treated?

Treatment usually starts with new eyeglasses. If eyeglasses don’t provide adequate vision, then contact lenses, usually rigid gas permeable contact lenses, may be recommended. With mild cases, new eyeglasses can usually make vision clear again. Eventually, though, it will probably be necessary to use contact lenses or seek other treatments to strengthen the cornea and improve vision.

However, most recently, researchers in Japan and Wales found that human cells reprogrammed to become stem cells were able to form cornea tissue in lab dishes. This was reported on March 9th in the Science and Medicine publication, Nature. The stem cell tissue was used to repair the damaged outer layer of the cornea in rabbits. In a separate study also published March 9 in Nature, researchers in China and the United States coaxed stem cells in the eyes of a dozen babies born with cataracts to regrow clear lenses.

The researchers also studied 37 babies who were born with cataracts. Regular cataract surgery, which involves removing the cloudy lens and replacing it with a plastic one, was done for 25 of the babies. In the remaining 12 babies, doctors made a small incision in the side of the sack containing the lens and extracted the cataract, but didn’t replace the lens. Stem cells in the sack generated a new lens within about three months of surgery.

While both studies are technically proficient and provide new approaches to treating cataracts or corneal injuries, neither will soon be ready for widespread use in the clinic, says Henry Klassen, an ophthalmologist at the University of California, Irvine School of Medicine.

Sources:

https://www.sciencenews.org/article/new-techniques-regrow-lens-cornea-tissue#video 

http://www.bbc.com/news/health-28106253

http://www.webmd.com/eye-health/eye-health-keratoconus

How to Treat a Poison Victim

FDWWL3XG5FRB66D.MEDIUMHelping a poisoning victim can be tricky, since there’s no one-size-fits-all solution. But in every case, it’s vital to find out what the toxin is and seek help.  This blog post includes emergency tips to help prepare for identifying and treating a poisoning victim.

If you need to evaluate a child for poisoning, or if someone refuses to answer questions about what they may have ingested, as in the case of a suicidal person, you can look for these common signs.

The victim may have burns or redness around the mouth or lips, or burns, stains and odors on their body, clothing, or other objects nearby. They may also have paint, powders, or other liquids around the face and nostrils. Likewise, a strong chemical odor, such as gasoline or paint thinner, may be on their breath. Look for any empty medication bottles or scattered pills, or spilled or empty containers for chemical, paint, or household products. The individual may show signs of nausea or begin vomiting, become drowsy or unconscious, experience difficulty breathing, or even respiratory arrest. The victim may also be agitated or restless, or seizing or twitching uncontrollably. Assume that the person is poisoned until proven otherwise, and take action on treating a poisoning victim. If the person has no symptoms, but you suspect poisoning, call your regional poison control center. Provide age, weight, and any information you may have about the poison, such as how much of it was ingested and how long since the person was first exposed to it. If possible, it will help to have the pill bottle or container on hand when you call.

Helping a poisoning victim can be tricky, since there’s no one-size-fits-all solution. But in every case, it’s vital to find out what the toxin is and seek help.

Step 1: Call your local emergency number to request help.

Step 2: If the poison is emitting fumes or there is a strong chemical odor in the room, move the person into fresh air.

Step 3: Put on gloves, if available, to prevent contamination. Check for any remaining poisonous substance in the victim’s mouth. If you find any, wipe it away. If the poison is spilled on the person’s clothing, remove the clothing.

Step 4: If the victim isn’t breathing, and you have a CPR mask or face shield, and you’re certified CPR, begin rescue breathing.

Step 5: If poison for exposed on bare skin or in the eyes, flush with lukewarm water for 20 minutes or until help arrives.

Step 6: If the toxin is a household product, check the label for advice, or contact your local poison-control hotline. Do not induce vomiting or administer a charcoal slurry unless instructed to do so.

Step 7: If the victim goes to the emergency room, take the pill bottle or package that contained what was ingested. That will help doctors start proper treatment immediately.

Source: Johnson, R. (2012). The ultimate survival manual. San Francisco, CA: Weldon Owen.

4 Signs of Graft Rejection

corneal_transplant Hargrave Eye Center BlogA cornea transplant is most often used to restore vision to a person who has a damaged cornea. A cornea transplant may also relieve pain or other signs and symptoms associated with diseases of the cornea.

In corneal transplant surgery the scarred or damaged cornea is removed and replaced by a human donor cornea called a graft. Corneal transplant surgery also is called penetrating keratoplasty or corneal grafting. Your eye is the recipient eye because it receives the graft. The other person’s cornea is the donor cornea or donor tissue because the cornea is being donated or given to you.

There always is a possibility that the body will reject the graft. This is like an “allergic” reaction of the body against the donor cornea. It can occur any time after the surgery. There is a good chance this can be treated successfully if you act immediately. There are four danger signs you must know, according to the University of Michigan Kellogg Eye Center in Ann Arbor.  If any of these occur and last for more than 12 hours, you should call your ophthalmologist – even if it is a weekend or a holiday.

To remember the signs of graft rejection, remember the letters: R S V P:

Redness – For a few weeks after surgery, your eye may be red. If at any time your eye begins to get redder, you should call your ophthalmologist. You easily can check the redness of your eye by looking into a mirror and pulling down the lower lid. Look carefully at the white part of the eye, especially in the area next to the cornea.

Sensitivity to light – Bright lights may seem irritating to your eye after surgery. This, too, slowly should get better. If you notice your eye becoming so sensitive to light that you feel like covering it, you should call your ophthalmologist.

Vision changes – Your vision most likely will improve gradually after your surgery. Make a habit of checking your vision every day. Check it at about the same time and in the same light. Pick an object in your house that has some pattern or detail to it. Look at the object with your operated eye while covering the other eye with your hand. If your vision seems to be getting worse, you should call your ophthalmologist.

Pain – It is normal to have occasional small twinges of pain in your eye. If your eye develops constant pain or dull aching that lasts several hours, call your ophthalmologist.

Make a habit of checking your eye every day. Check your vision at about the same time and in the same lighting each day, perhaps at the same time you do another routine activity, such as brushing your teeth.

Source: Mayo Clinic WebsiteUniversity of Michigan Kellogg Eye Center 

The Role of Bioflavonoids

hargrave eye center Bioflavonoids are a group of thousands of nutrients found in plant foods.  We actually don’t need to eat bioflavonoids for our bodies or cells to function, but we get a lot of benefits when we do:

These nutrients are not only antioxidants, but are anti-cancer, anti-infectious (i.e., they boost your immunity), anti-allergy, and anti-inflammatory. And pretty delicious too: coffee, tea, chocolate (dark, without the sugar and fat), and berries are high in bioflavonoids. Bioflavonoids are also found in red peppers, sweet peppers, citrus fruit, garlic, spinach, and apples.  That’s why “an apple a day keeps the doctor away,” but its smart to eat more than just apples, because our bodies need more antioxidants than one apple a day provides.

In binding metals, bioflavonoids prevent them from causing oxidation within your body.  You may be thinking, I have metals in my body?  Yes, you do — everyone does.  And having some metal is good for you, just like having some vitamins and some bacteria. Think of iron, for example. But unfortunately, science has shown that most of us come into contact with far too much metal in our environment.

Metals are in our air, our drinking water, our soil, and in our food, even in medications. In fact, some vitamin and fish oil pills have metals, which can stem from their sources or their manufacturing.  Metals also leach into our food supply from the diet of farm animals or from processing meats, as shown in many documentaries concerning the source of animals products in the United States and elsewhere.

Unfortunately, these are just a few ways we can unknowingly come into contact with toxic metals. But there are also a few targeted ways to avoid known sources of ingested metals.  This blog post outlines the top 3:

1. Avoid processed foods. The more your meal is processed, the more machines your food has come into physical contact with.  The more machines your food touches, the more likely that metals from those machines have leached into it.  If you eat unprocessed foods, the chance of it coming into contact with metals in minimal at best. And don’t forget about all those other oxidants that go into processed foods.  If possible, go organic, to avoid herbicides and pesticides that can contain toxins and metals such as arsenic.

2. Avoid air pollution. From cigarette smoke to car exhaust, to other gas fumes, these pollutants contain toxic metals that, once inhaled, may be immensely hard to get out of your body.  Even as you walk around an idling car or a person smoking outside a building, simply increasing your distance can help minimize your contact. Also, be sure to jog or bike away from busy roadways if you can.

3. Avoid toxic metals at home. Beyond lead paint, art supplies can contain mercury; plastics (such as vinyl) that are used to make lunch boxes, toys, and furniture can contain lead and toxins; some costume jewelry and even children’s jewelry can contain toxic metals including lead and cadmium; and dish ware can contain lead.  Test items in your home for lead.  A home test kit is easy to buy. Pay attention to where the things you buy are made and avoid buying products made in countries whose products test positive for lead in your home today.  While you can’t go back in time and mitigate past risk, you can make healthier choices for your family.

Source: Adams, N. (2014). The Power of Oxygen. In Healthy vision: Prevent and reverse eye disease through better nutrition. Lyons Press.

Protect Your Eyes

 

Eye-Protection-tips-660x330Protecting your eyes starts with the food on your plate. Many of us have heard that carrots are good for the eyes; however, eating a diet rich in fruits and vegetables, particularly dark leafy green is important for keeping our eyes healthy also.  Studies have shown that nutrients such as omega-3 fatty acids, lutein, zinc, selenium, and vitamins C and E may help slow the progression of or even ward off macular degeneration can cataracts.  Eating a well-balanced diet also helps people maintain a healthy weight.  People who maintain a healthy weight are less likely to develop obesity-related type 2 diabetes.  Diabetes is the leading cause of blindness in American adults.  Regularly eating these foods can help lead to good eye health:

  • green leafy vegetables such as kale, spinach and collards eggs,
  • nuts beans and legumes salmon, tuna, halibut, and other oily fish
  • oranges, lemons, limes, grapefruit

The American Academy of Ophthalmology currently recommends that people who work on the computer for long periods of time do the following:

  1. Use a current glasses or contact lens prescription.
  2. Some people over 40 years of age may need a special prescription specifically for computer use.
  3. Some people may also need glasses to help with contrast, glare and eyestrain when using a computer.
  4. Position your computer so that your eyes are level with the top of the monitor which allows you to look slightly down at the screen.
  5. Try to avoid glare on the computer screen from windows and lights.
  6. Use an anti-glare computer screen if necessary.
  7. Choose a comfortable and supportive chair with your feet positioned so that they are flat on the floor.
  8. If your eyes are dry, blink more or use artificial over-the-counter lubricants.
  9. Remember 20-20-20.

 

Corneal Transplant Surgery: What You Should Know

hargrave eye centerYou may need a cornea transplant if your cornea no longer lets light enter your eye properly because of scarring or disease.  The first cornea transplant was performed in 1905 by Eduard Zirm (Olomouc Eye Clinic, now Czech Republic), making it one of the first types of transplant surgery successfully performed.  

According to the Mayo Clinic, a cornea transplant, also called keratoplasty, is a surgical procedure to replace part of your cornea with corneal tissue from a donor. Your cornea is the transparent, dome-shaped surface of your eye that accounts for a large part of your eye’s focusing power.  A cornea transplant can restore vision, reduce pain and improve the appearance of a damaged or diseased cornea.  Most cornea transplant procedures are successful. But cornea transplant carries a small risk of complications, such as rejection of the donor cornea.

Types of cornea transplants include:

  • Penetrating (full thickness) cornea transplant. This involves transplanting all the layers of the cornea from the donor.
  • Lamellar cornea transplant. During this procedure, the surgeon only replaces some of the layers of the cornea with the transplant.

ocular healthExperts know more about the long-term success rates of penetrating cornea transplants, which use all the layers of the cornea.  Success rates are also affected by the problem that needed to be fixed with the transplant. For example, research from WebMD has found that the new cornea lasts for at least 10 years in:

  • 89% of people with keratoconus
  • 73% of people with Fuchs’ dystrophy
  • 60% to 70% of people with corneal scarring

The cornea tends to heal slowly. To help protect your eye in the days after the surgery, your doctor may ask you to wear a protective shield over it.  You will need to use eyedrops for several months after the transplant which can then be reduced to one drop a day or discontinued. The stitches may remain in your eye for months or years. Your eye doctor can remove them in a simple procedure during an office visit.  Your vision may improve slowly after the surgery. It’s important to avoid any possible trauma to your eye, such as from sports. This can damage your new cornea. You should report new irritation or any decrease in vision to your corneal surgeon. These may be signs that your body is rejecting the donor cornea. Most transplant rejections are fully reversible with steroid eyedrops if detected early enough.  Rejection may even occur years after the surgery. If you notice any of these signs that last for more than six hours, call your eye doctor promptly. The doctor can give you medicine that can help prevent as well as treat rejection.

Eye donors are screened to eliminate those with diseases that may be transferred to you via the donor cornea. The donor’s general and eye medical history are reviewed, and blood tests are performed for hepatitis and AIDS. AIDS has never been transmitted via corneal transplant, but it is tested as a precaution. While none of these tests are infallible, there is only a remote chance of transmitting disease via corneal transplantation.

 

Ocular Health & Lasik Surgery: A Surprise Success

LASIK surgeryResearch has shown that inflammation is one of the primary underlying causes for dry eye. Currently, there is only one FDA-approved pharmaceutical for treating the inflammation found in people with dry eye. However, many patients with moderate to severe symptoms often find that these treatments are just not enough.  Some experts have estimated that as many as 8 out of 10 LASIK patients deal with some dry eye symptoms in the weeks following their procedures.  But, that is not to say that LASIK surgery doesn’t have its benefits.

LASIK surgery is an experiential offering, especially amongst a burgeoning customer market.  Millennials (defined by the Pew Research Center as being between the ages of 18 to 34 in 2015) are projected to number 75.3 million, surpassing the projected 74.9 million Boomers (ages 51 to 69).  Laser vision correction is transformative.  This means a patient can enter your office one day with a visual acuity of 20/400 and return the following day 20/15. Millennials’ young age suggests an enduring lifespan to look forward to.  As specialists in refractive and implant vision correction, eye care specialists are taking advantage of this opportunity to help them see and, ultimately, experience life as it happens.

Additionally, millennials are not the only group that LASIK surgery has attracted in recent years.  In July 2015, the New York Times shared an article recounting the exceptional story of “Banner”, a five year old female Falcon that underwent a second round of laser eye surgery which helped her to fly again.  The falcon previously had cataracts.

Ocular Health

“Banner”, the five year old female Falcon stares at the camera lens which she is now able to see after three separate eye surgeries. Her handler, Nancy Cowan is in the background.
 
 
(Image Source: Alan MacRae/for the Monitor)
 

The doctor who performed the surgery, Dr. Andre A. D’Hemecourt said he needed to get approval before actually operating on a nonhuman patient.

Nevertheless, recent integration of state-of-the-art medical technology can be credited for an increased demand in eye care services and ocular health experts among nontraditional patients.  In April 2015, The Huffington Post published a blog article about a woman who sought an ophthalmologist after losing her entire eyesight in one eye.  The woman describes her experience as a point in time that gave her “an appreciation for something else, something I had never given a moment’s thought, as so often happens with watershed moments in our lives.”

Stories like these remind us not to take our eyes for granted.  WebMD suggests following these simple six steps for maintaining good eye health:

1. Eat for Good Vision. Regularly eating these foods can lead to good eye health:

  • Green, leafy vegetables such as spinach, kale, and collards
  • Salmon, tuna, and other oily fish
  • Eggs, nuts, beans, and other non-meat protein sources
  • Oranges and other citrus fruits or juices

2. Quit Smoking. Smoking actually makes you more likely to get cataracts, optic nerve damage, and macular degeneration.

3. Wear Sunglasses. Protect your eyes from the sun’s ultraviolet (UV) rays.

4. Use Safety Eyewear. Especially if you work with hazardous or airborne materials on the job or at home.

5. Look Away From the Computer Screen. Or, try to at least! Staring at the computer screen for too long can cause eyestrain, blurry vision, trouble focusing at a distance, dry eyes, headaches and neck/back/shoulder pain.

6. Visit Your Eye Doctor Regularly. Everyone, even young children, should get their eyes examined regularly.  It helps protect your sight and see your best.