Spotting health issues in your eyes
EYES AND HEALTH: The eyes take in images through light entering the cornea which then focuses on whatever object is being looked at. To control the amount of light, muscles in the iris adjust the size of the pupil and then the light moves onto the lens to focus the image on the retina which sends the information onto the brain. Everything we see is interpreted by the brain. Many people have vision problems such as nearsightedness or farsightedness that can easily be fixed using aids like glasses, contacts, or laser eye surgery. Many eye problems are not visible just by looking in the mirror, which is why regular eye exams are necessary. Signs that there may be a potentially serious issue with the eyes include being abnormally sensitive to light, redness or tearing, white pupils, and constant rubbing of the eyes. If you experience any of these, see an ophthalmologist as soon as possible. (Source: www.livestrong.com)
SIGNS: We use our eyes to see the world around us, but they could also give insight into what is going on inside our own bodies. Signs to look out for in the eyes are:
· One pupil larger than the other. Pupils of different sizes may be linked to a higher risk of stroke, brain aneurysms, and brain or optic nerve tumors.
· Constantly dry eyes could be due to an immune system disorder experienced by women over 40 years old called Sjogren.
· Bloodshot eyes may signal high blood pressure, which can cause blood vessels to twist and burst leading to red-eyes.
· Watery eyes can also signal a potential health problem. If the eyes are watery it could be a viral infection, but if the fluid is sticky, then a bacterial infection may be to blame.
HOW TO AVOID EYE PROBLEMS: With how important eyes are to people’s overall health, you should make sure everything stays in tip top shape. Other than receiving regular eye exams, there are also foods that can help eyes stay healthy. Get enough carotenoids in your diet; the antioxidant is found in leafy greens like kale or spinach and has proven to prevent eye degeneration brought on by aging. More antioxidants that are good for eyesight are beta-carotene and lycopene, found in various fruits. If you’re eyes are easily fatigued, eat blueberries! The berries will reduce eye fatigue. Finally, add broccoli, green peas, corn, and turnips to your diet; the lutein and zeaxanthin rich foods lower the risk of cataracts. (Source: www.huffingtonpost.co.uk)
Julia Haller, MD, ophthalmologist-in-chief at the Wills Eye Hospital, talks about a new therapy for macular holes.
Can you explain what the drug for macular holes is?
Dr. Haller: The drug, Ocriplasmin, acts on the vitreous gel and its attachment to the retina. The vitreous gel fills the back part of the eye and it is adherent to the retina. The retina is the tissue in the back of the eye that acts like the film in a camera. That is what actually takes the picture when the light gets focused on it. The macula is the center part of the retina. It’s the part that you use to recognize faces, read, and see street signs; the central part of your visual field.
How does a macular hole form?
Dr. Haller: As the eye ages, the vitreous gel that fills the central space gets more liquid and it gradually peels away from the retina. That is called a posterior vitreous detachment. That happens in everybody. In most people it is somewhere after the age of 60 or so. In some people, as it is peeling away, it pulls on the retina and it can distort it and cause swelling. In the extreme example, it can actually pull a tiny hole in the central retina and then you’re missing part of that central visual field.
That can lead to blurry vision?
Dr. Haller: The traction on the central macula leads to distortion, blurry vision, small areas of missing visual field, and if you actually get a macular hole, you are completely blind in that central area where you no longer have any functioning retinal tissue.
Is this the area that helps you with recognizing faces, colors, your visual acuity; all those things?
Dr. Haller: Yes, exactly right. So, the person who this is happening to starts to notice that something is not quite right when they look around. They have trouble reading. They may notice that lines start to look wavy. They may notice that they cannot follow along when they are trying to read the paper or read a book. They cannot read signs. They notice that it is almost like a funhouse mirror effect. Sometimes when they look at people lines will bend in and people’s faces will look like an hourglass.
Before this, surgery was the only option?
Dr. Haller: Exactly. In the past, the only option we had for these patients was surgery. As a result, we would wait until things got bad enough that it was worth the risk of an operation before doing surgery. Sometimes people would have permanent loss of vision and they would not be able to regain it completely because we waited until it was bad enough to be worth going to the operating room.
So, now you have this new medication that can be injected into the eye?
Dr. Haller: Precisely. It is a drug that is injected into the eye in the office. It is an outpatient procedure. We do many of these injections for other reasons. Injections in the eye are a common treatment for macular degeneration and diabetic eye disease. In this particular case, the patient gets a single injection. Then they start to notice some floaters, maybe some flashing lights as the vitreous gel peels away. In up to 40% of cases, for example of macular holes, the hole will close without any surgery.
So it is a lot less invasive. Do they still need to lay flat like they do with surgery?
Dr. Haller: No. That is one of the huge advantages particularly for macular hole patients because those patients normally not only are having an operation, but their eye is filled with a temporary gas bubble and they have to actually keep their head down so that the bubble pushes up against the edges of the hole and that means that they have got to have face-down positioning. Of course they have the normal postoperative medications and they have up to a month or so where they cannot fly in an airplane. They have severe motility restrictions as well as the standard risks of any operation, such as bleeding, infection, retinal detachment, and virtually everybody gets cataract progression as well as a cataract operation.
How does that compare then with the new medicine?
Dr. Haller: It is like night and day. Within a few days, your symptoms are gone. You have got recovery of vision. You have none of the risks of surgery, none of the postoperative positioning requirements or medications, far less expense, far less inconvenience, and far less down time. It is really miraculous.
So you don’t have to worry about cataracts and you don’t have to worry about being facedown?
Dr. Haller: Exactly. That inconvenience and side effect is a deal breaker for some people. They decide they are just going to live with really no functional central vision in one eye rather than have surgery. It is paradigm shifting for us. It is something that the ophthalmology community and particularly retina specialists are very excited about.
It does not prevent cataract?
Dr. Haller: It prevents the type of cataract that develops after retinal surgery, because you don't have to have retinal surgery. You don’t have the cataract surgery that you inevitably would need following the macular hole operation.
So, the majority of people would be interested in this if they are aging or near sighted?
Dr. Haller: Yes. The population that this would apply to is people who are developing this aging process in the vitreous. It tends to be people who are in their 50s, 60s, 70s, and older. Women, more than men, get macular holes. It is more common in people who are near sighted than in people who do not need to wear glasses for distance vision. It is potentially applicable to a host of other even more common diseases, but we have to test them. So, there is some thought that it may be valuable even in diseases as common as macular degeneration and diabetic retinopathy, but, that remains to be seen. There is a lot more work to be done. It is a very exciting new drug and we think it may be applicable to a lot more diseases.. For example, in diabetics, the most severe blinding complication of diabetes is when you have abnormal blood vessels that grow up out of the retina and they grow onto the back of the vitreous gel. The vitreous gel serves as a scaffold for them to grow. So, if you could remove that scaffold, there would be nothing for them to grow on. Potentially, you could save that most complicating and blinding form of diabetic disease from happening. Now, that has not been proven yet. It’s just a potential application, but that is one we are very excited about.
With this drug you can catch it early, instead of having to wait until they are nearly blind like they would do with the surgery?
Dr. Haller: Exactly. We know that if you operate at an earlier stage patients do better, but they also incur the risk at an earlier stage. So potentially as soon as people start to become symptomatic and have problems, we can offer them this as an alternative to surgery, a pharmacologic surgery and then they do not need to go onto an actual operation.
* For More Information, Contact:
Wills Eye Institute
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