Eye Care Blog

The lack of routine eye care was the likely cause of the unrecognised but significant and preventable vision loss and eye disease among 11% of HIV-infected adults attending an HIV treatment site in Kampala, Uganda, report Juliet Otiti-Sengeri and colleagues in the Journal of Acquired Immune Deficiency Syndromes.

While roll-out of antiretroviral therapy will continue and so help reduce HIV-related eye problems, two issues will need to be addressed by HIV treatment programmes note the authors. HIV-infected individuals will continue to present with advanced disease and with opportunistic eye infections that require specialised treatment. In addition, antiretroviral therapy can cause immune recovery inflammatory syndromes of the eye, which also need to be managed.

Before antiretroviral therapy was available an estimated 50-75% of HIV-infected individuals in North America and Europe developed vision-related illnesses with cytomegalovirus (CMV) retinitis the primary cause of vision loss.

Prevalence of diseases of the eye in sub-Saharan Africa is estimated to be between 30 and 45%. Eye tumours and opportunistic infections causing vision loss and illnesses of the eye in resource-poor settings are often due to tuberculosis, Cryptococcus and toxoplasmosis, unlike resource-rich settings.

In resource-poor settings the more common and treatable causes of vision loss are also associated with opportunistic eye infections due to herpes viruses, in particular cytomegalovirus and to a lesser degree herpes simplex virus and varicella zoster virus.

Since the widespread introduction of antiretroviral therapy in Uganda in 2004 approximately 120,000 are now getting ART out of an estimated 1 million people living with HIV. Yet, the authors note there is little known about the extent of vision loss among people infected with HIV.

From July 2003 until August 2004 the authors screened 1,212 HIV-infected adults 18 years of age or older attending an outpatient infectious disease clinic at Mulago Hospital in Uganda to determine the extent of vision loss as well as to describe HIV-related eye diseases.

The clinic is an HIV research, training and treatment site and Mulago Hospital is Uganda’s national referral hospital and a university teaching hospital.

Those with vision loss of 6/9 or less in one or both eyes had a comprehensive diagnosis and evaluation of the eyes. 6/6 (or 20/20 in the United States) is the universal standard for ‘perfect’ vision and is a measure of how well a person sees and is referred to as visual acuity.

136 (11.2 %) patients (CI: 95% 9.49-13.13) had a vision loss of 6/9 or worse in at least one eye of which 66 (49%) had reduced vision in both eyes.

Eye diseases associated with legal blindness (6/60 or worse) were mostly related to opportunistic infections. Of the 136 patients 16 (11.8%) had cataracts, 20 (14.7%) had optic nerve disease, 35 (24.3%) had refractive errors (failure of the eye to focus causing blurred vision) and 44(32.3%) had uveitis (the third leading cause of blindness in the developing world: inflammation or swelling of the middle layer of the eye structure).

Opportunistic infections primarily associated with vision loss with the potential to cause blindness, note the authors, included CMV retinitis, toxoplasmosis of the eye, deterioration of the optic nerve as a result of cryptococcal meningitis and ethambutol optic nerve toxicity.

They also stress that ART presents an additional risk factor for loss of vision with CMV retinitis in the form of immune recovery uveitis.

Ethambutol toxicity is a known cause of visual loss for patients on TB therapy. The authors suggest if patients are monitored for loss of vision and of colour whilst on therapy blindness is preventable.

The authors highlight that before the availability of ART vision loss because of cryptococcal meningitis or TB treatment in sub-Saharan Africa was rarely seen in HIV-infected individuals. This may be a reflection of improved treatment and so survival.

The authors note factors that may have contributed to an underestimation of the prevalence of vision loss and include: patients with altered mental states, a common symptom of cryptoccocal meningitis, were excluded from the study; the high rate of CMV retinitis and subsequent short survival in sub-Saharan Africa – people are too ill to present for care; and those with eye disease but as yet undeveloped vision loss would also have been missed.

The authors note that a minority (26%) of those with impaired vision mentioned the fact during the screening process. While 40% were aware of problems but did not mention it to the physician, 34% only realised they had problems when tested.

The lack of specialised eye care, assessment and awareness about eye disease in HIV treatment sites, they stress, probably plays a part in adding to cases of preventable blindness.

People will continue presenting at a late stage of HIV infection putting them at increased risk of developing vision problems. The authors note that most treatable visual problems develop in people with a CD4 count under 200/mm3.

While they acknowledge the difficulties of identifying patients with eye disorders at a treatable stage the authors suggest simple steps to take. For example, medical assistants can determine visual acuity by asking questions about visual symptoms – floating spots, flashes, and visual loss.

Inpatients and those in hospice care can be examined by binocular indirect ophthalmoscopy (a simple hands-free device worn on the head that allows the doctor to examine a patient’s eyes) would, they suggest, result in identifying large numbers of potentially treatable cases.

They suggest “Research on cost-effective methods of identifying patients who are not under care is needed.” and conclude that “The problem of HIV-related blindness is extensive and deserves more attention as HIV care scales up worldwide.”

Today Cranberry residents will see the grand opening of the first Visionworks? location in western PA.  Visionworks is a full-service optical retail center that features several thousand private label and designer frames along with contact lenses at value prices. One of the nation’s leading providers of eye care services, Visionworks will debut its first local store in the Cranberry Commons Mall.

“Butler County residents can count on Visionworks for high-quality frames, lenses, contact lenses and sunglasses – plus the leading technology in vision correction,” said John DiIanni, Regional Vice President.  “And because we have a state-of-the-art processing laboratory on site, we can provide one-hour service on most prescriptions.”

The Visionworks store in Cranberry Commons features:

* Exclusive brands developed to provide Visionworks customers with fashionable designer styling and impeccable quality at a fraction of the price
* Best-selling designer brand frames including Bebe, GUESS, Nine West, Gant, Liz Claiborne, Candies, Rampage, Armani Exchange and Michael Kors
* The region’s largest selection of durable kids’ frames and a huge selection of impact- and scratch-resistant lenses
* A broad range of contact lenses and related products from leading manufacturers
* Convenient hours with stores open seven days a week including evenings
* In-store licensed Doctors of Optometry (no appointment necessary) who provide comprehensive eye exams and contact lens evaluations and fittings
* Acceptance of most vision insurance plans
* A 30-day money back satisfaction guarantee

Sankara Eye Hospital (SEH), Bangalore & Shimoga in association with Sightsavers International (SSI), UK, today organized a panel discussion on ‘Common Eye Problems faced by Children’ in the city today. Dr S Halkatti, Joint Director, Dept of Ophthalmology, Govt. of Karnataka, Dr Kaushik Murali, Director Nanna Kannu, Dr. Madhu Kumar, Consultant, Retina and Ocular Oncology Services, SEH and Mr. Srinivas, CEO, National Association for Blind, Karnataka presented their views and observations. The discussion highlighted the success of Public-Private Partnership in eye-care delivery throughout Karnataka through the National Programme for Control of Blindness. It also focused on common eye ailments in children, prevalence of retinoblastoma, and difficulties faced by visually challenged children and mainstreaming them in education and society. Panelists shared their thoughts on how early diagnosis could prevent serious ailments among children. The discussion also focused on how parents could identify symptoms of eye troubles, stages and diagnosis of eye cancer among children. It is noted that chances of treating eye cancer and saving life among children is high if treated early.

All the eye experts pointed out the importance of understanding the behavioral pattern of a child as it can help the parent to identify the child’s problem easily. The common symptoms faced by children such as Myopia, Lazy eyes, Monocular vision (vision in one eye), Squint, Cataract, some Retinal Ailments can be prevented through early detection. They also stressed on the need for regular comprehensive eye examination for all children to detect and treat visual ailments.

The event also saw the screening of an Animation Film ‘I Learn What I See’, which pointed out how a small problem like Myopia or nearsightedness could affect the psyche of a child and his/her performance, if left untreated. This in turn also influences the impression the child has on others.

According to Dr Kaushik Murali, Consultant Ophthalmologist and Director – Nanna Kannu, SEH, “Various interventions have shown vision problems to affect approximately one in 20 preschoolers. They also affect one in four school children. Though usually treatable, without early detection and treatment, children’s vision problems can lead to: permanent vision loss and learning difficulties.

“We have a comprehensive eye care programme for children called the ‘Nanna Kannu’ Program. The project aims to provide preventive, curative and rehabilitative eye care for deprived children across Karnataka. SEH has until now reached more than 31,000 children who have been screened for eye problems and provided with further treatment and rehabilitation wherever necessary. This initiative will now spread out to other parts of the state in order to serve many more needy children.”

According to Dr. Halkatti, Joint Director, Dept of Ophthalmology, Govt. of Karnataka,“The National Programme for Control of Blindness is the most successful Public Private Partnership in the field of healthcare. It is the responsibility of all stakeholders including Governmental Agencies, NGO’s, Doctors, parents and teachers to be aware of the possible symptoms of vision problems, and assist the children to improve their vision as this can have an impact all aspects of the child’s life.”

Mr Srinivas, CEO NAB Karnataka pointed out that, “The NAB Karnataka Chapter has been in the forefront of providing care to the blind for over 3 decades. We are happy to associate with Sankara Eye Hospital and Sightsavers International in ensuring that all Children identified in the programme are provided means of Integrated Education and have the confidence to stand Shoulder to Shoulder with their Sighted Counterparts.”

The Ocular Oncology Department at Sankara has treated the largest number of children with ocular cancers in the state of Karnataka in the past year. Under the leadership of Dr. Mahesh Shanmugam we are currently offering surgical care and chemotherapy and would upgrade our facilities to provide brachytheraphy (radiation treatment) in the coming month , said Dr Madhu Kumar,Consultant , Retina and Ocular Oncology Services.

The panel discussion is a part of ‘Nanna Kannu’, a comprehensive eye care programme for children in Karnataka. The Institution aims to screen 300000 underprivileged children with the support of Various Governmental Agencies, school teachers and local organizations. Sankara Eye Care Institutions provides quality eye care under the ‘Gift of Vision’ outreach eye care programme which has benefited many including children in Mysore district.

Eye muscles being relaxed and elastic is considered as a secret of good eyesight. When we grow old, all the body muscles become to lose its elasticity and vigor. That is why our eyesight will be poor when we grow old. There are a lot of bad habits leading to bad vision. Fortunately, there are ways to avoid the bad results of poor vision. The key method is to relax your eye muscles.

If you can not see the word in distance, you must try your best to see clearly, but you have put your eyes at risk. You are straining your eye muscles. So please go near to see and try not to be frustrated with it if you are not able to see clearly.

Direct and excessive exposure of eyes to cold wind and bright light are another causes of poor eyesight, especially after continuous long time work. So please do not stare at computer or television too long. You are suggested to have a break every half an hour and do eye exercise.

Squinting should be avoided for good eyesight too, as squinting too often will put your eye muscles in strain. The best condition that eyes see an object is that they see without any muscular effort. However, squinting just breaks the balance. So try not to squint in dim light and massage your eyebrows once a while.

The wrong posture while reading should also be responsible for fatigued eyesight. For if you are used to slump, lean or read too close, your eyeballs will be much strained as a result of gravity. The best way to read is to put the book paralleled to your eyes about 20 inches away and sit straight. If you get used to reading too close to the book, you are gradually forming myopia.

Except for posture, you should also care more when reading. For example, after reading half an hour, you are recommended to take a rest and do eye exercises or your eyes will feel tired, and thus strongly strained. Furthermore, when reading, it is better to look at the white spaces in between the lines but not the lines themselves and not the individual letters. Because this method is just sweeping your eyes over the white background and use your eyes effortlessly.

There are a variety of eye exercises which can relax eye muscles.

1. Look as far as you can and meanwhile breathe deeply; rub the face and forehead while bending over, then do the massage around the eyes gently.
2. Stand up straight, simultaneously, do the exhaling and inhaling repeatedly. Lean your head to each side and do the inhaling and exhaling again to relax the gaze.
3. Close your eyes, massage your eye sockets with your palms softly.

In one word, good eyesight is mainly due to relaxed eye muscles. So focus on eye relaxing when you do anything.

more info

·Tips to Enhance Your Eyesight

·Keep away from blurred vision!

Recently, many eyeglasses are sold at very low price. And some eyeglasses are sold at particular price, of which $10 eyeglasses are very typical. $10 eyeglasses are proved some of the cheapest eyeglasses in the market. Though those eyeglasses are sold very cheaply, they are very popular and many glass wearers are arduous for them. Here are some facts about their popularity among the public.

The foremost factor that leads to the popularity of those glasses is cheapness. What can you do with $10? Can you imagine how much you have to pay for a pair of eyeglasses at optical stores? Generally, each pair of those glasses is sold for $200 on average. In this sense, we can know that $10 can only buy the nose pad of those eyeglasses. Most of us will never believe that there are $10 eyeglasses in the market. The price is so low that all glass wearers are greatly excited. Those $10 eyeglasses have made it possible that eyeglasses are affordable for people of all works of life, however low their income might be. In most cases, eyeglasses are expensive and we dare not to change them though it is needed. $200 is the total income of a whole week. With the emergence of $10 eyeglasses, we can change glasses at anytime if we like, they are really cheap- the sum for a pair can now buy 20 pairs of $10 eyeglasses. No wonder so many people love to wear them.

Another important factor is fashionable elements can also be found in $10 eyeglasses. It is now the 21^st century and fashion has been pervaded into every corner of our lives. We can not imagine what our lives will become of without fashion. Consequently, fashion is also an essential part of $10 eyeglasses. Some particular $10 eyeglasses can help highlight our personal tastes and elegance. For example, some young girls are crazy about those red $10 eyeglasses with well-decorated fringes. Still, for some of us who are fashion-oriented, they deem $10 eyeglasses as their accessories. Like their shoes, necklaces, clothes, etc. $10 eyeglasses can be used on different occasions. Some of them tend to buy many pairs of $10 eyeglasses with different styles. Some of you may say we can buy some cheap eyeglasses frames for one pair of lenses. The fact is that some frames are still much expensive than those glasses and buying several pairs of $10 will cost less than one hundred dollars. Furthermore, sometimes, particular glasses are equipped with certain lenses and frames, due to fashion. Therefore, buying fashionable $10 eyeglasses is a better alternative for most of us.

The third important factor is they can be obtained in a very convenient way. Some optical stores will sell $10 eyeglasses in some particular zone. If you want to buy them there, you may ask the salesmen for help. Of course, some other tips, as you do in other time, should also be taken into consideration. If the optical stores are too far from your house, you can also choose to buy those eyeglasses online. Purchasing online is now becoming the most popular method to get $10 eyeglasses. Generally, there are more styles and items to choose from. After clicking the mouse, you can get them at your house several days later.

Doubtless, there are also many other factors for the popularity of $10 eyeglasses. If you want to get them, just be quick.

Most of us tend to think that glasses and contacts are our best choices when we have some eye problems. Any better way that can help us to enhance our eye sights? Haven’t all human beings got their own natural recovering systems? Maybe we can revitalize these systems in some ways.

In fact, people have got the answers to these questions many years ago.

There is a tendency that people who begin to wear glasses become younger and younger. Especially, many school children have to wear glasses at very early age. This is because of modern civilization in which they spend more time sitting in front of computers, watching TV, etc.

In fact, our eyes are composed of many tiny muscles. When they lose their elasticity, we will have to suffer from some eye problems. So we should try to exercise these muscles. Some statistics prove that doing some specific eye exercises can really improve people’s visions.

Stress is the main cause of eye problems. Thus we should try to relax ourselves both mentally and physically. If we can not eliminate the metal strain, we may suffer from eye sight loss. Most of us have never noticed that there is very tight relation between physical strain and eye strain.

Eyes are compared to the window of the world. And we should spare no effort to maintain our eye sights. In that sense, we should know the causes and solution of eye problems.

We can try to use Bates’ Methods that is one of the most effective natural methods for vision improvement.

more info

·Care Your Eyes

·Actions you take to remove your glasses

According to the Bates theory, blurred vision eye problems such as myopia, hypermetropia and astigmatism are mainly due to the shape change of eyes caused by the high tension of the muscles around eyes. Fortunately, most of these eye problems are not permanent. Most of us know that these eyesight problems can be solved through artificial ways such as wearing eyeglasses or contact lenses, or laser eye surgeries if glasses are not acceptable. However many people ignore that there are many natural methods that can improve your vision.

Although most of the natural ways may need a long period of time before they absolutely solve your eye problems, it is a wise decision to use such simple and safe methods to improve your eyesight. So if you have any problem of eyesight, it will be very beneficial for you to read the following three tips which are very useful for improving your vision naturally. If it does work, please share this information with your friends who also have eyesight problems.

Fist is to relax your body and your mind when necessary. Our body speaks, for instance, your eyes feel tired and irritating when you spend too much time before computer. When you aware of these signals of your eyes, you have to stop your work for a while and give them enough rest that they require. It is much better if you can lie down for a few minutes to give your whole body and your mind a rest, not only your eyes, because vision is not only connected to physiological but aso psychological.

The second suggestion is to visualize pleasant mental images. Visualization these pleasant images can relax your body and mind which is important to have positive effort in improving your vision.

The third tip is to do eye exercise everyday. Eye exercises are specially developed to improve your eye vision by strengthen the muscles around the eyeball and improve the circulation of the blood around the eye area. You can find them in books or internet sites. By doing eye exercises, the state of your eyeball can recoil from deformation naturally.

If you want to know more about Vision knowledge, then feel free to visit http://blog.firmoo.com/eye-health

Age-related macular degeneration is the leading cause of blindness among people over 50 years old in industrialized countries. Scientists have found that antioxidants such as carotenoids are helpful in decreasing the risk of AMD. In particular, spinach is one of the best sources of carotenoids, which are considered as normal macular protective pigment (MPP).

UV rays have been long reported to damage eye tissues because they produce free radicals in the eye. What’s more, blue light is particularly harmful to the macula which is the central retina. A common way to fight against these harmful rays is to wear sunglasses with HEV and UV protection. And brown or amber sunglasses are believed to block out HEV most effectively.

In addition to sunglasses, experts also recommend some nutrients for AMD prevention. Zeaxanthin and lutein are two of the powerful antioxidants that have been found in the macular tissue of the retina. Both of the two nutrients protect the photoreceptors against oxidative stress, inflammation and even degeneration.

There are many sources of zeaxanthin, including foods and supplements. Those foods include egg yolks, squash, pumpkin, orange peppers, collard greens, tangerines, romaine lettuce, green beans, spinach and so on. In addition, supplements from various brands such as Eye Promise-Restore are helpful for those who can not get adequate amounts of zeaxanthin from a diet.

Omega-3 fatty acids are also thought to help maintain eye health. The most common way is to consume fish oil extracted from cold water fish such as salmon, mackerel, anchovies as well as sardines. Ordinary people are encouraged to contain certain amount of fish oil in the diet.

Glutathione is an intracellular antioxidant. It can literally prevent degeneration in the delicate photoreceptor cells. This type of antioxidant is a billion more times potent than Vitamin C in neutralizing those free radicals in the eye.

One’s lifestyle is also critical. Obesity and smoking are both thought to increase the risk of severe macular degeneration by 4 times. And regular exercises are usually helpful in maintaining a health life.

more info

·Factors associated with macular degeneration

·Types and treatments of macular degeneration

Thelma Tenorio and Joanne Jones, eye care technicians from Marianas Eye Institute, returned from the Hawaiian Eye Conference held in Kauai, Hawaii last week. The two were sent by Marianas Eye Institute for ongoing education and training.

“It was a great experience,” said Tenorio, who has been with Marianas Eye Institute for seven years. “There were about 1,200 people at the conference. Jo and I attended the technician and allied health program where we had a chance to gain new knowledge and polish our skills as eye-care technicians.”

Jones said the conference made her want to continue pursuing her own education. “It was my first time to go off-island. Seeing so many young people in the field of medicine inspired me to keep going with my education,” she said.

Both Tenorio and Jones completed the first part of their examination as Certified Ophthalmic Assistants while at Marianas Eye Institute.

“The conference was a great update, and it exposed us to new technologies,” said Tenorio. “For example, we saw that more things are moving toward 3-D imaging. We also learned a lot about the federal regulations that guide medical practices, and also realized how up-to-date we are at Marianas Eye Institute.”

Jones echoed these: “Being around other technicians, and realizing that we have skills and knowledge that many of them don’t have helped us see just how well-trained we are at Marianas Eye Institute. We felt lucky that our doctors have given us such in-depth training.”

On the new technologies unveiled at the conference, Tenorio said, “We got a sneak peek at some of the new technologies that have come out in the past few months, and got to use them. At Marianas Eye Institute, we’re committed to making sure the people of the Commonwealth continue to have access to the highest levels of eye care, so we received training on some of the new technology that will be arriving soon at our clinic. I was able to better understand why Retina Physician magazine called Marianas Eye Institute ‘one of the best-equipped eye clinics in the Asia-Pacific region.’”

But it wasn’t all work and no play. The two technician managed to see a bit of the island. “We did some shopping for our families, spent time with our leaders, and enjoyed the company of some of the new people we met,” said Jones.

Also in attendance was Russ Quinn, the CEO of Marianas Eye Institute. “This is the third year we’ve taken our staff with us to this conference. It’s great to see them realize their own talents, and to see just how advanced they are, and our office is, in comparison to many offices in the States,” he said.

The Hawaiian Eye Conference is four conferences rolled into one. There is a special educational program for technicians, one for administrators, a comprehensive ophthalmology program for doctors, and a retina conference for doctors dealing with retinal disease. The conference attracts participants from around the world.

“I attended the administrators conference. Much of the focus was on enhancing our practices to serve our patients more efficiently and in a cost effective manner,” said Quinn, “but the most fun part of the conference was to spend time bonding with our staff.”

Dr. David Khorram, MD rounded out the Marianas Eye Institute team who attended the conference. “It’s a great opportunity for me. When I’m on Saipan, there are no other ophthalmologists around. Meetings like the Hawaiian Eye Conference are a chance to get together with colleagues from around the world to spend a week studying the advances in our field. I always learn a few new techniques that help us ensure our patients are getting excellent care,” he said.

Dr. Khorram, the director of the Center for Advanced Diabetic Eye Care at Marianas Eye Institute, divided his time between the comprehensive ophthalmology program and the retina program. “This is an ideal conference for me because it deals very heavily with two diseases that I treat a lot at Marianas Eye Institute: cataracts and diabetic eye disease. I spend quite of bit of time throughout the year keeping up with advances in these fields, and writing about them. The conference is a way to study with friends and colleagues in my field. It’s great to bring the advances in eye care and ophthalmic surgery back home to the CNMI,” he explained.

Dr. Khorram explained that both cataract surgery and diabetic eye disease have undergone remarkable advances in the past years. “From this conference I was able to bring back some new instruments that will both enhance the safety of the cataract surgery we perform, and improve the healing time. I was also able to bring back the newest research in diabetic eye care so that the options we provide to our diabetic patients remain up to date with the scientific research,” he said. “Marianas Eye Institute is also becoming active in the field of clinical research, which allows us to bring the most advanced treatment options to our patients. The conference provided an opportunity to engage with other doctors who are co-investigators.”

Almost all eyeglass or contacts manufacturers advocate that their products are the best solution to vision problems such as nearsightedness, farsightedness and astigmatism. It is true that eyeglasses and contact lenses with vision correction are the two most common ways to correct refractive errors in many people. And eyeglasses and contact lenses in various brands and types have been widely accepted by a large population. But they are not the only solutions that truly work.

Eyeglasses and contact lenses are costly and require regular maintenance. For some wearers, it is bothersome. Fortunately, there are still some vision healing programs. One of them named Vision Without Glasses has been tested and proven to be helpful.

A common question about Vision Without Glasses is that how does it helps people with vision problems regain eyesight naturally. The program actually has designed an overall system that teaches people step by step to regain eyesight gradually. The first step aims to get rid of potential factors that may worsen the eyesight.

In addition, Vision Without Glasses offer some scenarios for people’s recognition. If some scenarios cause less than optimal performance in a person, they should be removed in his or her daily life. After that, healing process can begin.

The effectiveness of Vision Without Glasses is most widely concerned. This program offers some guiding exercises for eyesight healing. Some patients have received good visual outcomes that they regain normal eyesight without the help of eyeglasses or contact lenses. Such a good result is quite worth the money of the program. It is worth mentioning that visual results occur only after a considerable period of time.

According to Vision without Glasses, corrective eye surgeries are dangerous and costly. It is not a good choice to resolve vision problems. For those deciding to have a corrective surgery, best surgeon with enough experience should be ensured.

more info

·Can Eyesight Be Restored Naturally?

·How to protect your eyesight