Age-Related Macular Degeneration (AMD) is more common than Alzheimer’s, Parkinson’s, and Breast Cancer combined. AMD is the leading cause of blindness for those over 55 in the United States. AMD is an inherited disease and affects 1 in every 5 families. Likely anyone over age 60 knows someone affected by the disease. In Arizona, AMD is a significant public health concern as our population is aging and it will continue to affect a growing number of patients and their families.
Risk factors for developing the disease are:
• family history
• low macular pigment levels
• gender – it is more common in women
• smoking – 3x greater risk
• poor diet – no enough green leafy vegetables and fruits
• high cholesterol
• sun exposure – ultraviolet light
Looking down the list one can see that most of these risk factors can be reduced with lifestyle changes. Our segment on the show discussed how two of these risk factors, low macular pigment and sun exposure, can lead to the disease and how they can also be addressed.
The macula is an area of retinal tissue in the back of our eye that is responsible for our acute 20/20 vision. Macular degeneration in large part is caused by oxidation of the macular retinal tissue created by ultraviolet light entering our eye. Another oxidative process is rust, so you can think of AMD as if the back of our eye were rusting.
The way in which AMD affects our vision is that it distorts our central, sharp vision. Images first become wavy and gradually start to lose their definition and patches of vision become blurred. As the disease progresses, color vision may also begin to be affected.
The good news is, our macula has a built-in protective layer of pigment that blocks harmful light from causing oxidation, think of this as our internal rust-proofing. This pigment is made of three compounds called carotenoids, Lutein, Meso-Zeaxanthin, and Zeaxanthin. So when we have a healthy layer of macular pigment, we have internal protection form sunlight’s harmful effects.
However, not all of us have a healthy layer of macular pigment. As a general rule, individuals that have a light complexion, (light hair, eyes, and skin), will have less macular pigment. We also tend to lose our macular pigment as we age.
Now the good news is that numerous studies show that when a macular pigment supplement is taken orally, it absorbs into the blood serum and is deposited in the eye to rebuild this protective layer, and over a period of time the pigment is restored to a healthy protective level.
Currently, there is only one supplement available, MacuHealth, which contains the proper levels of all three components of macular pigment, Lutein, Meso-Zeaxanthin and Zeaxanthin. These pigments are called carotenoids, over 600 of which are found in nature but only three in are found in the eye. We also know that of the three, Meso-Zeaxanthin blocks the widest range of blue light and is the most powerful protector against oxidation. MacuHealth contains 10mg of Meso-Zeaxanthin, which is considered the key carotenoid in protecting the macula.
Anyone living in Arizona should consider taking MacuHealth as UV light exposure is a significant risk factor for tissue damage leading to AMD. Anyone with a family history of AMD, has a light complexion, or spends a lot of time outdoors should consider taking it. Just like we can’t put on too much sun screen, we can not have too much protective macular pigment.
Of note, MacuHealth is an all natural product. Carotenoids are found in our diet, Lutein and Zeaxanthin are found in fruits, vegetables and eggs. Meso-Zeaxanthin is also dietary, but not in things we normally eat; it is found in the skin of trout and salmon – we usually leave the skin on our plate, it is found in shrimp shells, it is found in oysters. However we can not eat enough to make much of a difference in our macular pigment, we are talking pounds of vegetables to get the same dosage of carotenoids found in MacuHealth.
MacuHealth is only available from the manufacturer or in doctor’s offices.
Last Updated (Tue, Dec 6 2011 5:10 pm)
Questions and answers regarding GLAUCOMA
1. What is Glaucoma?
Glaucoma is a disease in which the Optic nerve is damaged causing progressive and irreversible loss of vision. The Optic nerve is what connects to the eye to the vision centers in the brain.
2. Are there different types of glaucoma?
There can be many causes of glaucoma, but the underlying common thread is irreversible damage to the optic nerve. The two most common types of glaucoma are open angle glaucoma and angle closure glaucoma.
Open angle glaucoma accounts for over 90% of cases. Individuals with open angle glaucoma usually have no symptoms until the end stages of the disease, thus, it has been referred to as the “sneak thief of sight”.
Angle closure glaucoma occurs in less than 10% of cases. Angle closure glaucoma does have symptoms which include sudden onset of hazy vision, rainbows around lights, nausea, vomiting, headache, and pain around the eyes. When an individual is in angle closure, it is considered a sight threatening emergency as without proper treatment, sight loss can occur rapidly.
3. How common is Glaucoma?
Glaucoma is the 2nd leading cause of blindness in the world
• 1 out of every 200 people below the age of 50 have it
• 2 out of every 100 people age 40 to 50 have it.
• 1 out of every 10 people over the age of 80 have it
• 4 million Americans have glaucoma but only ½ know it
• It can occur at any age, even infants
4. How does it affect your sight?
Glaucoma affects vision from the outside in, meaning peripheral vision is lost first. In the latter stages, central vision is affected which can lead to blindness.
5. What are the risk factors?
High intraocular pressure (IOP) in the biggest risk factor, although many cases of glaucoma may not have overly high readings when measured. This may be due to diurnal fluctuation (most of us have our highest IOP when sleeping) or in many cases, normal pressure glaucoma may be the culprit. Family history is another risk factor.
6. How can you tell if you have Glaucoma?
Seeing your eye doctor for an eye examination on a yearly basis is the best way to maintain your vision. Diseases such as glaucoma have no symptoms in early stages when most amenable to treatment. In open angle glaucoma, 50 % or more of vision may be lost before becoming noticeable. Vision loss from glaucoma is permanent.
7. What tests are performed to check for Glaucoma
While IOP testing is considered a standard part of any eye exam, examination of the optic nerves often provides more information when screening for glaucoma. If there is suspicion of glaucoma, more tests may be ordered. These include:
• Visual field testing - We lose our peripheral vision first with glaucoma so a detailed analysis of our field of vision checks for functional optic nerve damage. This is a very detailed test that can determine if small patches of our peripheral vision are fading long before an individual would notice any change.
• Digital imaging of the optic nerve and retinal nerve fiber layer- The optic nerve contains over 1.3 million individual nerve fibers. A scanning test providing a three-dimensional digital image of the nerve and its associated nerve fiber layer of the retina can tell if damage has occurred.
• Photography of the optic nerve – this documents the current appearance for future comparison
• Corneal thickness measurement – Pachymetry measures the thickness of the central cornea. Individuals with a thinner than average central cornea are at a greater risk of vision loss from glaucoma.
• Drainage angle assessment – gonioscopy allows for viewing the structures responsible for fluid flow from the eye. If the drainage angle narrows, IOP can increase. If the angle narrows to the point of closure, it can cause an angle closure attack as described above.
8. Are there treatments for Glaucoma? Is it curable?
In the majority of cases glaucoma is treatable with medication in the form of eye drops. In fact it is rare to see vision lost from glaucoma as medications have advanced greatly over the past 10-15 years. However, if glaucoma goes undiagnosed, particularly in those that do not receive regular eye exams, vision loss can occur which is unfortunate as it is preventable. Advanced cases of glaucoma that do not respond to medical therapy my require surgery to maintain sight. Glaucoma is highly treatable, it is not curable.
Last Updated (Mon, Mar 21 2011 9:55 am)
See Dr. Gong and Dr. Vogl on ABC15! Click on the link below and find out more information about Optometric Vision Therapy!
What is Optometric Vision Therapy?
Optometric Vision Therapy is an individual program of treatment designed to improve visual function and performance. Its proven results are derived from vision based neurological and neuromuscular conditioning. It is a treatment modality for disorders including, but not limited to:
Strabismus (eye turns in or out)
One can learn to use vision more effectively with lenses, prisms, filters, electronic targets with timing mechanism, optical instruments, and specialized medical equipment for feedback to effectively enable visual skills to become automatic in the patient.
The main benefits of optometric vision therapy include improved visual information processing and improved ability to sustain visual function over time. The American Optometric Association found that 35-40% of all children with learning disabilities have visual problems. At least 20% of children with learning disabilities have significant visual processing problems and 15-20% of them lack visual efficiency skills.
Vision Therapy relieves eye strain, visually induced headaches, inability to concentrate with near visual tasks and reduces loss of place, reversals and complaints of moving print when reading or writing. Optometric vision therapy also improves visual development and is part of a multi disciplinary effort following stroke or head injury.
Signs and symptoms to look for when suspecting a vision problem:
Physical signs or symptoms:
ADD/ADHD and Vision Problems:
Vision problems that are untreated can elicit the same symptoms that are commonly associated with ADHD. Recent research at the Children’s Eye Center at the University of San Diego showed that children with Convergence Insufficiency (inability to align the eyes inward for prolonged periods) are three times as likely to be diagnosed with ADHD than children without the disorder. Doctor Granet commented, “We don’t know if Convergence Insufficiency makes ADHD worse or if Convergence Insufficiency is misdiagnosed as ADHD. What we do know is more research must be done on the subject and that patients diagnosed with ADHD should also be evaluated for Convergence Insufficiency and treated accordingly.
25% of children may have a learning related vision problem. One study showed that 13% of children between 9 and 13 years of age suffer from moderate to marked Convergence Insufficiency.
What are learning-related visual problems that can have a significant impact on learning?
- Poor eye tracking skills
Are 3-D movies or video games harmful?
BBC News (9/30/11) reported a study of the impact of 3D in the classroom has found that it improves test results by an average of 17%. The research conducted in 7 schools across Europe found that the 3D helped children concentrate more.
In order to see in 3D, one must align and focus both eyes on an object and then combine the visual images into one clear and single 3 dimensional image. The ability to see in 3D is more sensitive than the standard eye chart that we have used for the past 150 years because 3D viewing requires both eyes to work together as they converge, focus, and track the 3D image. For the 1 in 4 children that may have underlying issues, lack of 3D perception can help identify these undetected problems.
The American Optometric Association recommends knowing the 3 D’s of stereoscopic 3D viewing:
- Is the 3D viewing experience not as vivid as it is for others watching the same picture?
Last Updated (Sun, Dec 4 2011 9:58 am)
Resolving Eye Fatigue
A. Uncorrected refractive error
B. Near Viewing tasks
II. What are the Symptoms of Eyestrain?
III. How do near visual tasks cause eyestrain?
V. Relief of Symptoms
Last Updated (Sun, Nov 21 2010 3:02 pm)
A recent study conducted across five European countries showed that 50 percent of women in their 40s felt that contact lenses would have a positive effect on their quality of life. 41 percent said they would try contact lenses if their eye care practitioner recommended them and 22 percent said that contact lenses would be their first choice of vision correction.
They say 40 is the new 30, do you want to wear reading glasses?
It is inevitable; all of us start to lose our focusing ability around age 40. Whether you have never worn glasses or currently wear contact lenses, putting on reading glasses can be a blow to our perception of youth. However, with technological improvements in optical design, multifocal contact lenses can provide clear vision far, near, and everywhere in between.
Multifocal contact lenses work on the principle of simultaneous vision. Images at all ranges are focused for our eyes. Our visual processing then takes over to determine which image is clearest for the object we are looking at.
Are multifocal contact lenses right for me?
If you require distance and near vision correction, or just need reading glasses, multifocal contact lenses may be of benefit.
What should I expect from multifocal contact lenses?
The goal is to enable one to have functional vision without the use of glasses. For example, the ability to read your cell phone as well as street signs, or read a document while attending a presentation.
Will I still need reading glasses?
While many who wear multifocal contact lenses will not require any other correction, for some, mild powered reading glasses may be necessary in low illumination or for very fine print.
Can I wear contacts lenses if my eyes are dry?
Possibly. New lens materials transmit high levels of oxygen to the eye's surface while maintaining wetability. Luckily, demonstration lenses are avaialble that allow one to "live with" lenses for a trial period to determine if acceptable comfort can be achieved.
What if I have an astigmatism?
Multifocal contacts lenses are one the newest advancements in primary eye care. Weather your reading or driving, you can enjoy crisp clear vision with todays technology. Please contact one of the convenient locations of our Independant Primary Eye Care Physicians to schedule your multifocal contact lens evaluation.
Last Updated (Tue, Oct 18 2011 6:54 am)