CATARACTS

Mine eyes have seen...

By CASEY BUECHEL - Tribune Staff Writer
Wednesday, August 3, 2011 12:29 PM CDT

Casey Buechel

Last Wednesday I had the "extensive" cataract removed from my left eye.

Well, to be pedantically accurate, I didn't do anything except lay on the operating table sound asleep while the gifted and experienced Dr. Michael Minadeo removed the cataract from the eye.

Thank you, sir.

Thank you for your ability and your wisdom in hiring Dr. Mark Glanzer and Sharon and all the technicians who populate your office.

Thank you Robin Fincher and the Texas Commission for the Blind who have been so helpful when it came to the funding for the injection treatments in my left eye and the surgeries in both my eyes.

ADVERTISEMENT

God has blessed me and blessed me and blessed me this last year.

My eye problems first began before Christmas of 2010 and within four months, my eyesight had deteriorated so badly I could not drive or work.

It goes without saying that I believe, and my Mother believes, in the power of prayer.

But in addition I have friends, and my Mother has friends, who believe in the power of prayer.

Thank God for those friends.

For all my co-workers who carried my load for three months until the cataract was removed from my right eye and I could bring my (at the time) one good eye back to work.

For the Palmers, who made the decision to hold my job for me until I could come back to the office.

For Patty and Harley, for Ruby and Alma and Leon, for Sara and Ronnie, for my Aunt Peg and Aunt Gin and Aunt Dean and all my cousins, for Glen and Esther, for Mary and Ron, for Tim and Ken and John and Brent and Sheila and Joy,  for Jan and Wesley, for Deborah and for Pat (who have gone through their own hardened crucibles with humor and grace while I sometimes seemed [to me at least] to be trying for the Whiner of the Year Award), for Christine and Marilyn and Vivian and Lanell and Dee, for Lavonne and Jerry and Michelle, for Hula and Robby and Craig and Shannon and Lenda, for every one of you who prayed and who continue to pray for me and added me to your prayer lists -- Thank God for all of you.

For my Mother. Oh, my goodness, what would I have done without her?

For her faith and patience and wisdom and strength and humor.

For her generosity.

God has blessed me and blessed me and blessed me all my life.

And for His love I am thankful beyond belief.

TRAVEL MISHAPS

I left home a week ago to visit my parents in Mississippi. There are always mishaps when I travel. First I left my shampoo and conditioner at a friends house where I spent the night. Second I bought a new hair gel which came in a tube similar to my toothpaste. Well guest what? I put gel on my toothbrush. I realized it only because the colors are different. I quickly washed out my toothbrush. The phase only for external use flashed in my head. I guess I will have to mark the gel so II know what it is.

LIFE'S A BEACH

We live two hours from the South Carolina coast. I love going to the beach and picking up shells. I have a small collection. I love the white ones. Since I bead I have the smaller ones with a hole in the top strung with ribbon for my nieces to wear as a necklace. The very tiny ones we put is small bottles someone game me. Collecting shell is relaxing and fun. I even have bowls around the house full of shell. There are some from Savannah, Georgia to Myrtie, Beach, South Carolina.

LOW VISION BY DAVISVISION

Written by Adam Parrish, Davis Vision Staff Writer

Low vision is a visual impairment, not total vision blindness, which results in a permanent decrease in the acuity of an individual's vision field. Unlike normal vision impairments such as nearsightedness and farsightedness, low vision can't be fully corrected by using standard vision aids such as eyeglasses or contacts. According to the Association for the Blind and Visually Impaired (ABVI), an individual has low vision when "the better-seeing eye will not reach visual acuity of 20/70 or greater after the strongest correction aid is applied". This guide will help you understand and be able to identify the early warning signs of low vision, along with the resources available to help individuals with low vision accomplish a variety of everyday tasks.
Common conditions that result in low vision include cataracts, stroke, glaucoma, mascular degeneration, diabetic retinopathy and retinal detachment. The five most common types of low vision, as defined by the American Optometric Association/1, are as follows:

• Loss of Central Vision – The loss of central vision creates a blur or blindspot, but side (peripheral) vision remains intact. This makes it difficult to read, recognize faces, and distinguish most details in the distance. Mobility, however, is usually unaffected because side vision remains intact.
• Loss of Peripheral (Side) Vision – This vision loss is often referred to as "tunnel vision" and is the result of the inability to distinguish anything to the one side or both sides of a vision field, or anything directly above and/or below the eye level. Central vision will remain acute, making it possible to see directly ahead.
• Extreme Light Sensitivity – This vision impairment exists when standard levels of illumination overwhelm the visual system, producing a washed out image and/or glare disability. People with extreme light sensitivity may actually suffer pain or discomfort from relatively normal levels of illumination.
• Night Blindness – This results in the inability to see outside at night under natural illumination such as moonlight, or in dimly lighted interior areas such as movie theaters or restaurants.
• Blurred Vision – A general blurriness across the entire vision field causes objects, both near and far, to appear out of focus, even when the best correctional device is applied.

Early warning signs of low vision include difficulty recognizing objects up close or at a distance, differentiating between colors, and overall blurry vision. Individuals, through their primary eye care provider, should contact a Low Vision Eye Care Specialist who can perform a unique eye examination called a low vision evaluation. This type of examination involves a multitude of tests that assess the range of the vision field, ocular perception and sensitivity, assessment of any ocular injury or disease, and overall mobility of the eye. After this series of tests, the low vision specialist will perform tests with various telescopic and magnification aids to determine which low vision aid will provide the best visual field enhancement.

Speaking with a low vision specialist about rehabilitation services and useful tips to overcome everyday challenges will greatly increase the success of living with low-vision.

There are a large number of vision aids available to individuals with low vision and based on the ocular evaluation, a low vision specialist may prescribe a single low vision device or a combination of visual devices. Some low-vision adaption devices include magnifying glasses, large print objects (i.e. books, phones), and talking devices that speak simple information such as the time, date and directions. The most common low-vision aid is absorptive lenses that are worn over prescription eyeglasses to eliminate harmful sunlight. Absorptive lenses increase the contrast of objects and help individuals when transitioning between light and dark surroundings.
Other devices such as closed circuit magnifiers, lens-mounted magnifiers, and reading machines, are used in rare occasions when low-vision severely impairs an individual's vision field. A closed-circuit magnifier is a specialized video camera that magnifies an object more intensely than standardized magnifiers, and projects the image onto a screen such as a television or computer screen. Lens-mounted magnifiers are a small tool that combines the magnification powers of a microscope and telescope, and allow the ability to magnify objects up close and improve distance vision.
Speaking with a low vision specialist about rehabilitation services and useful tips to overcome everyday challenges will greatly increase the success of living with low-vision. Family and friends are also valuable resources and can provide assistance when facing challenging tasks. By using available resources and with the help of low vision aids, individuals with low vision continue to lead independent and fulfilling lifestyles.


http://www.davisvision.com/Low-Vision/


 ^1/ American Optometric Association; “Common Types of Low Vision”; http://www.aoa.org/x5244.xml; accessed 01/03/2011"

MY NEW iPAD

A few weeks ago I bought the new IPad. I just love it. This is the first time I'm trying to post using it. I have been out of town taking care of my mother so I haven't had anytime to post. Updates to follow.

Hearing impaired have a higher risk of falling

I wanted to post this piece about falling and hearing loss because some of us with vision loss also have a hearing loss. I'm one of them and I've fallen twice in the past month. 

Even mild hearing loss triples the risk of difficulties maintaining gait and balance, a study shows. 
A link between hearing loss and falling was found by American researchers. The study indicates that having even a minor hearing impairment can increase the risk of a fall.

“People with impaired hearing have poor awareness of their overall environment, and that makes them more likely to trip and fall,” says Dr. Frank Lin, an Otologist and epidemiologist at Johns Hopkins University School of Medicine, USA.

“It might also be that with hearing loss, the brain becomes overwhelmed by the demands on its limited resources,” says Dr. Frank Lin and suggests that many take their gait and balance as a given, in reality it is cognitive appropriation. If hearing loss imposes a cognitive load, there may be fewer cognitive resources to help maintain balance.
Results

In the study, 2,017 participants aged 40 to 69 had their hearing tested and answered questions about whether they had fallen in the past year. The data was collected over four years and found that people with a 25dB (mild) hearing loss were nearly three times more likely to have a history of tripping often. For every additional 10dBs of hearing loss, a 1.4 times higher risk of falling was seen.

The findings were published in the Archives of Internal Medicine, and they could help researchers develop new ways of preventing falls. 

 

Carbohydrate and Macula Degeneration

Written on July 11, 2011 by Robert K. Su MD

Macula degeneration is usually age-related, thus, is commonly called age-related macula degeneration or AMD. Macula degeneration is an eye disease involving the central portion of the retina. Retina is the area in the back of the eye where receives the light or image and relates it in electrical signals through the optical nerve to the brain. Therefore, damage of the macula can cause loss of central vision, which should be clear and sharp.  The disease was not well known by the general public until the recent decades when its prevalence had continued to increase [1]. However, a report in 2011 showed that the prevalence of macula degeneration has begun to fall possibly because of individual’s healthier lifestyle [2].There are two types of AMD, namely, wet AMD and dry AMD. Wet AMD occurs rapidly with growing blood vessels behind the macula. These blood vessels are fragile and leak blood and fluid , which raise the macula from the retina that results in loss of central vision. On the other hand, dry AMD occurs gradually and damages the macula cells and results in blurred vision first and progressively in loss of vision. The patient with dry AMD might feel that he needs more light in reading or viewing. Dry AMD has three stages, namely, early, intermediate, and advanced, for the degree of damages to macula cells. Sometimes, the patient may have yellow deposit(s) behind his retina, which are called drusen. The sizes and numbers of drusen increase as the degree of dry AMD advanced. The dry AMD is more common than the wet AMD [3].The greatest risk factor of AMD is age. AMD generally affects female more than males. Other risk factors of AMD include smoking, obesity, white more than black, and a positive family history. However, more studies have found both AMD and cardiovascular disease share common risk factors [4, 5]. Thus, avoiding the risk factors of cardiovascular disease is likely helpful in preventing or reducing the risk of developing AMD. Consequently, National Eye Institute encourages individuals to eat healthy foods such as green leafy vegetables and fish, to stop smoking, to prevent hypertension, to avoid overweight or obesity, and to exercise regularly.
Studies have shown diabetes mellitus is positively linked to the prevalence of AMD [6]. In January 2011, Chiu CJ et al cited in an article that the glycemic index of foods is positively linked to the risks of diabetes mellitus, cardiovascular disease, and recently to AMD [7], like the cases with retinopathy, even in those patients without diabetes mellitus [8]. These findings underscore the reiteration by this author that repeated spikes of hyperglycemia result from carbohydrate consumption, particularly in excess, is the risk factor of many diseases including AMD, even before these individuals are diagnosed with diabetes mellitus. With diets high in carbohydrate consumed by a majority of the population, it is understandable that the mass of one’s beta cells is likely continuing to reduce because of damages to beta cells by repeated hyperglycemia after meal. The prevalence of diseases increases as the individual is aging. [9]
Studies have also found AMD is a result of inflammation. [10, 11, 12] Reports have also shown hyperglycemia is both inflammatory and pro-inflammatory, which increases inflammatory factors such as C-reactive protein and cytokines [13]. Therefore, an axis of unrestricted carbohydrate consumption — postprandial hyperglycemia — postprandial inflammation — development of diseases including diabetes mellitus, cardiovascular disease, and AMD is evident clinically. Preventing repeated hyperglycemia from dietary carbohydrates should be the first and ultimate step in preventing diseases including age-related macula degeneration..
Robert Su, Pharm.B., M.D.
References:
1.  The Eye Diseases Prevalence Research Group “Prevalence of Age-Related Macular Degeneration in the United States.” Archives of Ophthalmology. 2004;122:564-572.
2.  Crystal Phend  “AMD Prevalence Falling in U.S.” Medical News, Ophthalmology. January 10, 2011.
3.  National Institute of Health “Facts About Age-related Macula Degeneration.” Health Information.
4.  Snow KK & Seddon JJ “Do age-related macular degeneration and cardiovascular disease share common antecedents?” Ophthalmic Epidemiology. Volume 6, Number 2.
5.  Cimbalas A et al. “[Association of age-related maculopathy with ischemic heart disease and its risk factors in middle-aged population of Kaunas city].” Medicina (Kaunas). Medicina (Kaunas) 2004;40(7):671-6.
6.  Kelin R et al. “Diabetes, hyperglycemia, and age-related maculopathy. The Beaver Dam Eye Study.” Ophthalmology. 1992 October; 99(100:1527-34
7.  Chiu CJ and Taylor A. “Dietary hyperglycemia, glycemic index and metabolic retinal diseases.” Progress in Retinal and Eye Research. 30 (2011) 18e53
8.  Su RK “Diabetes Mellitus: A Diagnosis Too Late. (1 of 3).” The Blog. Carbohydrates Can Kill. April 7, 2010.
9.  Su RK “Diabetes Mellitus: A Diagnosis Too Late. (2 of 3).” The Blog. Carbohydrates Can Kill. April 14, 2010.
10. Kelin R et al. “Inflammation, complement factor h, and age-related macular degeneration: the Multi-ethnic Study of Atherosclerosis.” Ophthalmology. 2008 Oct;115(10):1742-9
11. Hollyfield JG et al. “Oxidative damage–induced inflammation initiates age-related macular degeneration. “Nature Medicine 14, 194 – 198 (2008)
12. Boekhoorn SS et al. “C-reactive Protein Level and Risk of Aging Macula Disorder.” Archives of Ophthalmology. Volume 125 No. 10, October 2007.
13. Su RK “Carbohydrates Can Kill: Hyperglycemia is problematic but preventable by restricting carbohydrates. (1 of 3).” The Blog. Carbohydrates Can Kill. August 16, 2010.

Follow Dr. Robert Su M.D. at :
http://www.carbohydratescankill.com

VICTORY FOR THE FEET

Victory for the Feet

A recent New York Times article asserts that an average person’s feet will travel the equivalent of three times around the earth in a lifetime. To keep feet happy, consider:

1. Shoe size matters. Throughout life, feet keep changing. If shoes hurt, try bigger ones.
2. Feet need air. To stave off fungus, keep feet dry and don’t always wear socks and shoes.
3. Foot shape makes a difference. Both fl at feet and high arches cause problems. For flat feet, use shoes or orthotics that support arch and heel. For high arches, wear roomy shoes. For more information visit:

www.newyorktimes.com and search for “Think of Your Poor Feet.”

NCCB Meets in St. Louis

The National Church Conference of the Blind has announced its 2008 convention, to take place in St. Louis, MO, from Sept. 13-18 at the Hilton Frontenac Hotel. The theme is “Equipping for Effective Ministry.” In addition to Biblical teaching, activities include a tour of the Museum of Westward Expansion and
a riverboat ride.

For more information, visit www.thenccb.com.

Lifeglow

July - August 2008: Vol. 25, No. 4

KETATOCONUS CORNEAL TRANSPLANT

Keratoconus is a central or paracentral cornea characterized by bulging forward of non-inflammatory thinning of the disease. The disease is common in young people, 70% of eye disease, the incidence rate of lower than abroad. Although many scholars study of keratoconus, but so far unknown etiology. Cone was found at histological fibrolamellar reduced collagen fiber diameter did not change, so that the bonding between layers may be the fiber is not enough, slip sheet between layers, leading to thinning.
Allergic disease is genetic and its possible causes. As the central area or near the central corneal area of thinning, leading to increase in corneal irregular astigmatism, myopia has been deepened and decreased visual acuity, seriously affecting the life and work and study, with the further progress of the disease, can result in corneal perforation, resulting in blindness. It is generally rigid contact lenses by correcting, penetrating keratoplasty to do serious, young lives could be done twice a corneal transplant.
Predilection keratoconus 16 - 20 years old young people, women more often involving the monocular start, and then the second eye disease, the prognosis, the latter better than the former. The clinical manifestations of early keratoconus in refractive error based, began to myopia, and gradually developed into astigmatism or irregular astigmatism, corrective lenses can generally; medium further decline in visual acuity, general corrective lenses can not be corrected vision with contact lenses. Slit lamp examination showed corneal thinning gradually to the top, projecting forward, and sometimes ruptured Descemet aqueous invasion, corneal edema and opacity may occur; the top of the late corneal scarring or often formed irregular linear opacities, corneal superficial There neovascularization, a high degree of decreased visual acuity, contact lens can correct vision.
Keratoconus cornea after corneal transplantation can be life-long use, this does not occur in the case of rejection, the general lamellar keratoplasty for keratoconus rarely occur after rejection. Therefore, early detection of keratoconus, early treatment is very important.
keratoconus corneal transplant


Keratoconus, the English abbreviation for the KC, is a protrusion of central corneal thinning, was characterized by a cone-shaped eye. Keratoconus can cause a high degree of irregular astigmatism and myopia of different degrees of visual impairment. 20-year-old high risk youth are keratoconus, both eyes usually have disease. Etiology of keratoconus is not clear, it was thought to be genetic abnormalities, it was also reported to the disease and endocrine disorders and allergic diseases, eye diseases also caused damage to the cornea may also be the direction of the keratoconus.
Myopia and myopic astigmatism resulting from decreased visual acuity should be wary of keratoconus, which is the more common performance. In this case generally have a high degree of astigmatism, and more with irregular astigmatism. Keratoconus corneal central area will be getting thin, bulging, round cone prominent, which is the origin of the name of keratoconus. To the late development of sudden acute corneal edema, opacity, so that visual acuity decreased sharply in the short term.
Keratoconus can be divided into two types: front-and rear-type, rear type is divided into full-and localized. Before and after puberty, usually in the eye disease, keratoconus in the early stages of disease when the myopic lens correction, due to irregular astigmatism and the need to wear contact lenses, advanced in need of corneal transplantation, but no matter what level of keratoconus, can not use drugs cure.
Corneal transplantation is an effective way to treat keratoconus, vision can not be corrected for, or keratoconus who developed rapidly. Keratoconus is a standardized, precise microsurgery, advanced form of surgery can effectively reduce astigmatism and postoperative visual acuity can be satisfied. As early as the mid-keratoconus, central corneal opacity without those lamellar keratoplasty may be considered, but not as penetrating keratoplasty visual acuity, acute keratoconus surgery should be postponed. Success rate of corneal transplants higher Cambridge Eye Hospital in Chengdu (Sichuan Province Red Cross Eye Hospital) has been successful for many from across the country successfully implemented in patients with corneal transplants.

PROSTHETIC EYES

Patient describing what it's like wearing a prosthetic eye with a Digitally Enhanced Iris Image and what it is like to work with Carole Lewis Stolpe. Best viewed in HQ. http://www.allartificialeyes.com