Eye care advice

Tomorrow (12 March 2014) is No Smoking Day. Smokers across the country are being encouraged to give up cigarettes for numerous health reasons. Many of the negative effects smoking has on the body are well publicised; heart, lung and mouth disease being some of the most common. However, few appreciate the effect smoking has on the eyes. Smoking is by far and away the most important modifiable factor in age-related macular degeneration (AMD), the loss of central vision. ‘Modifiable' means it’s something you can do something about about – i.e. by stopping smoking. There are other risk factors of some of which are modifiable (e.g. UV light exposure and diet) and others which are non-modifiable (e.g. family history). A series of studies have found a significant link between smoking and this form of eye disease. Cataracts are another eye condition associated with smoking. Cataracts are cloudy patches in the lens which cause visual impairment and various studies have found a link between smokers and the chance of developing cataracts. Although most people get cataracts as the get older, smokers get them younger and they develop faster. Less seriously, smoking can make your eyes dry and uncomfortable by affecting your tear film, the layer of liquid constantly covering the eyes. You should very quickly notice an improvement in dry eye symptoms if you give up smoking. So when you're considering quitting, give a thought to your eyes.

Earlier this month a new piece of technology was launched by Spritz which aims to dramatically change the way we consume printed content. The Spritz system basically fast-streams one word at a time so your eyes don't have to flicker back-and-forth (movements called saccades) to find the point where your brain can properly process them. The app, which will be available on some smartphones, can be customised to suit your own pace displaying from 250 to 1000 words per minute. The key to the success of Spritz is to stop the eye wandering on the page. When you read, your eyes seek out the Optimal Recognition Point of each word (OPR). This technology works out the OPR and highlights this letter in red further assisting the word recognition process. According to Spritz, only 20 percent of our time ‘reading' actually involves taking in content and during the other 80 percent our eyes wander around the page. There are definitely downsides. Sneeze and you might miss five words! And it definitely takes some of the leisurely enjoyment out of reading. But I think it could well have a place and I could have probably used it to good effect in my student days. Imagine if you've got an English literature assignment due and need to read War and Peace in 10 hours? Spritz could make that happen. Have a go and see what you think. www.spritzinc.com

I was very sorry to read of Dame Judi Dench's declining vision. Up for an Oscar this Sunday, the 79 year old is suffering with age-related macular degeneration (AMD). She has said she can no longer read and struggles to paint and watch films. Sadly the condition affects over 500,000 people in the UK to varying degrees, most of those being over the age of 60. The genetic element of the condition is well known and in Dame Judi’s case her mother also suffered from AMD. Visiting your optometrist regularly will ensure early signs are detected allowing the condition to be most effectively managed. Early signs can include blurred and distorted vision and straight lines looking wavy. Using our latest OCT scanners we are able to see cross-sections of the retina to find the earliest signs of AMD which helps us get you access to treatments as soon as possible. Lenses and glasses will help, certainly in the early stages, and there are some medications and nutrients available that can also slow the degeneration, depending on which variety you have (wet or dry). Because the disease only affects the middle of the eye, sufferers will never experience total blindness. Dame Judi has said she has no plans of retiring, showing that even at its more advanced stages, the disease should not mean a complete change to current lifestyle. Encouragingly there are many ongoing studies into the disease so we hope that some day soon a cure will be found. www.macularsociety.org

Vending machines are great. You're thirsty or desperate for a quick snack in the middle of a busy day and there in the corner of your eye is a vending machine. Ideal. A pound coin in, a can of juice out, problem solved. They are fit for this purpose. However, when Gillian was recently on holiday in Russia, she spotted a vending machine spouting out contact lenses. The first emotion is amusement – we've seen some other funny Russian customs in Sochi hitting the news recently. But the second emotion is worry. Eye care should not be dealt with on-the-go and I really hope never to see these machines in the UK. The concern is people will rely on these kinds of dispensers and forego a proper eye examination. CamOpt patients will know, the first half of your check up is spent looking at the suitability of your lenses. We look for any changes from your last appointment, talk about your lenses and whether they are still the best option for you, after all there are so many excellent options out there for each different individual. When it comes to eyes we are very individual so off-the-shelf and eye care shouldn't even share the same sentence. After that section, we whip you off to check the health of your eyes with the scanner and the biomicroscope, then off to another machine to check your peripheral vision. All the while we are looking for any signs of disease and damage. Our technology allows us to spot issues early so we can devise a plan to hopefully cure and certainly manage the problem. If you forgo your appointment with us, you risk not only wearing the wrong lenses, but missing vital signs of eye ill health.

This is a one for all our optometrist readers. It's one of those times when you think “why hasn't anyone thought of this before now?” During contact lens exams when patients remove their contacts, where do you put them? Chances are they've forgotten their case (not Cameron Optometry patients of course.) so you open a trial pack of solutions, chucking away all the bits you don't need or you buy a whole bunch of cases from a supplier for an extortionate price. I wanted a way to do it quicker, cheaper and better and came up with Lens Plate – single use disposable trays for temporary contact lens storage. Take one off the stack, use it once and dispose of it – totally hygienic for patients. But remember you don't have to be an optometrist to use them. They are now available online at www.lensplate.co.uk

I was saddened to read this story yesterday about trachoma, the leading cause of infectious blindness in the world. The most upsetting thing is that this village, where half of the people are at risk of blindness, is not unusual. In fact millions are affected worldwide. You may not have heard of it as it is unusual in the UK and a short burst of antibiotics usually sees it off. However in developing nations numbers with the disease are alarming. Like bacterial conjunctivitis, the disease is most common in children between one and five years old. If you have children and spotted the symptoms of conjunctivitis you probably popped in to see me, the GP or your local chemist, to get a course of eye drops and that was that – trachoma is just as simple to treat. However the medical care in the areas worst affected is just not there and untreated trachoma infections cause the inside surface of the eyelid to become rough and then scar. The scarring causes the eyelashes to start turning inwards where they scratch the cornea with every blink making it eventually turn opaque causing blindness after years of pain. WHO launched an initiative called “SAFE” which stands for Surgery for trichiasis (inturned eyelashes), Antibiotics, Facial cleanliness and Environmental improvement in the 1990's. Since its invention it has administered over 50 million antibiotic treatments however, clearly so much more needs to be done. Hopefully raising awareness of the disease in developed nations will help raise vital funds in a bid to stem the spread of trachoma. Find out more about this condition here

After years of exploration, I was delighted to read that scientists at Oxford Uni have succeeded in restoring the sight in people with a form of degenerative eye disease. Choroideremia affects about 1 in 50,000 people who see their eye sight deteriorating as the light-detecting cells in their eyes die, usually becoming completely blind during their mid-life – a disease not dissimilar to the more widely known retinitis pigmentosa. There has been lots of research in this area but this is the first real world example of success. Whilst the long-term effects are still unknown, the fact that the trial has had such early successes is a huge step forward and will give real hope to those suffering from various genetic eye diseases. And it doesn't stop there. There are many diseases with genetic components that affect eyesight, such as glaucoma which a number of my patients suffer from, and I am hopeful that the same principle could be used to treat a raft of similar diseases in the future. What is especially heart-warming, is that the research was funded by the Tommy Salisbury Choroideremia Fund set up by the parents of Tommy, a 13-year-old boy from Kent who was diagnosed with the disease eight years ago. Wouldn't it be great if he reaped the rewards of the research? Read more about it here

My first mobile phone made calls, sent about 200 characters of text and weighed enough that to use the term mobile was a slight exaggeration. My most recent phone looks like it might be able to download an app that can do my job for me! The app is currently being trialled in parts of Africa devoid of optometrists. Normal 0 false false false EN-US X-NONE X-NONE Having had the opportunity myself to visit Africa as part of a Vision Aid Overseas team I met many people who were effectively blind due to not having spectacles. The statistics are quite staggering. Of the 285million people worldwide that the World Health Organisation suggests are visually impaired almost 230 million could be cured by spectacles alone.    Recently Vision Aid Overseas has realised the enormity of the problem and has focussed more of its work on educating and training local people to provide their own eye care services.  Perhaps a tool for this in the future could be the PEEK mobile phone app recently reported on by the BBC. The app uses the phone camera to scan the lens of the eye looking for cataract, and by illuminating the retina with the camera flash it can look for disease at the back of the eye. A shrinking letter on the screen is used as a very basic vision test. The patients record and their exact GPS location is stored on the phone allowing the images to be e-mailed to doctors and the patients to be located should follow up be required.   At the moment the app is being trialled on 5000 people in Kenya. With the image of their eye being taken by both the phone and standard retinal cameras that are being transported in the back of a van. Doctors at Moorfields eye hospital in London are comparing the ocular images to see how good a job the phone can do.  While we are hoping to start sending out more communication to our patients via e-mails and mobile phones, we will not be using them for your annual eye exams ……. quite yet!

With yesterday officially being the hottest day of the year so far, and dare I say it, the good weather predicted to last into August, It is perhaps the first summer in many that we have had to think about the effects of Ultra violet (UV) light on our body. It is commonplace now to protect our skin with sun creams but what about protection for our eyes? While our bodies are wonderful at repairing and replacing some damaged cells, the crystalline lens of the eye is an exception that is never replaced. Therefore gradual UV exposure over the years can lead to the early development of cataract, causing reduced vision.  Ocular UV related changes are not limited to cataract but have a role in the development of age related macular degeneration , photo keratitis, pterygium and can cause melanomas of the skin around the eye and eyelids. Most sun damage is accrued during the early developmental years of life, perhaps only showing itself later in life. Therefore sun protection for children is vital. So how do we protect our eyes from the harmful UV exposure? A good pair of sunglasses is a great start. These should offer protection to the level of UV 400. This means that 99-100% of harmful UVA and UVB wavelengths are blocked out. The style and fit of the spectacles can also make a difference. The larger the lens, or the more wrap around the style then the more UV light is blocked out.  Be very wary of cheap sunglasses without the UV400 protection. The dark nature of these lenses causes the pupil to get bigger behind the lens, allowing even more harmful light into the eye. Standard spectacle lenses do not offer UV protection. A great benefit of many modern soft contact lenses and some RGP lenses is that they have a built in level of UV protection. This means the added benefit of year round UV protection as well as coverage of the whole eye. Good nutrition is another way of protecting the retina from potential UV damage. Lutein is an antioxidant that protects the delicate cells at the macula. It can be found in many of the ocular supplements you find at the chemist or in health food shops and naturally in dark green leafy veg such as Kale, spinach and broccoli.

Patients often tell us that at each visit we unveil some new exciting gadget or piece of technology for investigating the health of their eyes. It seems like that to us too! In this ever changing tecnhological world though, where our tools to image your eyes are constantly improving, what doesn't usually change is our understanding of the structure of the eye……until now… The transparent cornea at the front of the eye is merely 0.5mm thick , and has always been understood to have five distict layers. When you put your chin on the slit lamp during your consultation we can identify these separate layers which provides vital information as to the severity of your eye condition. However Prof Harminder Dua of Nottingham university has discovered a new layer in the cornea. At only 0.001mm thick the layer was discovered by experimentation on human eyes donated to research banks. The implication of this discovering could be very important for corneal surgery and the understanding of eye conditions such as acute hydrops, descemeteocele and some corneal dystrophies effecting the deeper layers of the cornea. During corneal surgery tiny air bubbles are injected into the corneal stroma. If these bubbles burst then damage is caused to the patients eye, but by injecting under the strong Duas layer we may reduce the risk of tearing and damage. Prof Dua suggests that many of the eye conditions that we know to affect the back of the cornea could relate to the presence of this new found layer. Corneal hydrops is one such condition. It is a buildup of fluid in the cornea that is common in patients with keratoconus and might be caused by a tear in Dua's layer.

If you would like to appreciate for yourself the impact that Glaucoma can have on your vision then there is now a clever App that can simulate the progressive visual loss that can be caused by Glaucoma. Glaucoma affects around 2% of the white Caucasian population in Scotland with approx 80,000 people living with the condition. In an attempt to increase awareness of the disease MSD UK, Moorfields Eye Hospital and the International Glaucoma Association (IGA) have developed a free app with 3 elements to it. The app uses the photo facility on the phone / tablet to simulate how the photo could look if you had glaucoma. You can adjust the slider at the bottom of the photo  to simulate different severities of glaucoma. There are also imformation slides looking at the anatomy of the eye and explaining the disease process.   To download the app look for Glaucoma SIM or go to www.glaucomasim.co.uk for more information.   While Glaucoma can not be cured their are many treatment options available to prevent the development or progression of visual loss. The Early stages of disease are commonly symptomless so regular eye examinations for all are key. There is a higher incidence of glaucoma in those over 40 years old, with a close family history of Glaucoma, and in asian and afro carribean populations.   The OCT scanner that we have had in the practice for a number of years is proving to be one of the most effective ways available to detect the subtle , early eye changes of Glaucoma. Normal 0 false false false EN-GB X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi; mso-fareast-language:EN-US;}

It’s not the sort of advice you might expect from your optometrist but current research from  McGill University in Canada suggests that playing the video game Tetris may be an effective way of improving a lazy (amblyopic) eye. Good vision requires more than just a healthy eye. The eye sends electrical signals via the optic nerve to the part of the brain used for visual processing. We call this process the visual pathway or visual system. The visual system is not fully developed at birth. Good development requires each eye to be seeing well in order to build the connections between the eye and the brain. If one eye sees better than the other, the connections it builds will be stronger, leading to a dominant eye that suppresses the other one. This development continues from birth until about 8 years old. During this time there is a chance to balance the two eyes by covering the stronger eye forcing the weaker eye to behave better. This is only successful in some children and generally accepted not to work in adults at all. The earlier that treatment is started the better the outcome. This is why eye testing from about 3 years old is advised in all children. This should be even earlier if you have a family history of eye problems, if you think you see a squint in your child’s eyes or have any concerns that they are not seeing well. So could video games offer the answer to improving vision in adults who currently have no other treatment options? By connecting differently shaped blocks as they fall in Tetris, the eyes are forced to cooperate with each other, alleviating suppression of the weaker eye and retraining the brain to use both equally. Results from recent research suggested promising improvements in the vision of the weaker eye and in 3D perception. Unfortunately kids, this has not been trialed on children yet, although an American trial is planned for later this year. So while we are not advising video games over homework quite yet, this might bag you another few minutes on your DS!

Both Ian and Gillian have been lecturing to other optometrists about eyelid disease. Our advanced qualifications in eye disease and its treatment (the ‘DipTP(IP)' after Ian and Gillian's name) means we see a lot and know a lot about all types of eye disease including eyelids. The eyelids form a key part of a healthy visual system and are because they are constantly on the move and exposed to the elements are prone to a whole host of conditions, some serious some benign. Gillian spoke at the York Local Optical Society and Ian at Optometry Tomorrow, the annual conference of the College of Optometrists. Feedback was positive and a number of the audience said they now properly understood eyelids and their management for the first time in their career. It's a complex business so if you've got problems with your eyes or eyelids, come and see and expert.

Both Ian & Gillian have been lecturing on Blepharitis and Eyelid Disease recently and some of the audience have been interested in our Lid Health Management Plan. You can download it below. Lid Health Management Plan

Many of us, myself included, take vitamins and supplements as part of our daily quest for a healthier lifestyle. Why are they good for us though, and which ones should we take to improve the health of our eyes? Omega-3 essential fatty acids (EFAs) are essential nutrients which our bodies cannot make or store. Current research suggests they offer many health benefits such as reducing blood pressure, protection from heart disease, improving cognitive function in Alzheimer's, and protecting our bones and joints. If you suffer from dry-eye you will be pleased to learn that the properties of Omega-3 can help you too. They have anti inflammatory properties that reduce the uncomfortable symptoms of dry eye, as well as improving the quality of the tear film. Research also suggests that a daily dose may reduce the risk of wet AMD and play a role in prevention of cataract. The two critical Omega-3 EFAs are EPA and DHA . You will see them listed on the back of your supplement bottle. The best sources of these Omega-3 EFAs are oily fish and fish oil supplements and they supply the preferred Omega-3 EPA and DHA that the body can most readily use. Flaxseed, found in nuts and dark leafy vegetables will also provide Omega-3, but not in the form that is most readily converted by the body. Our typical British diets of processed foods tend to have the wrong balance of EFA’s, having more Omega-6 than 3. While Omega-3 reduces inflammation, Omega-6 can cause inflammation. These 2 fatty acids compete for the same space in our body, so I would suggest you avoid supplements that provide both and opt only for Omega-3 fish oils. Supplements can be found readily in supermarkets and health food shops in both tablet and liquid form. Otherwise, embracing the Mediterranean lifestyle of a diet rich in unprocessed oils and oily fish should do the trick (and some more Meditarranean weather would help too I reckon). Please contact the practice if you would like any further advice.

As you may have noticed at your eye appointments over the last couple of years, in addition to taking a retinal photograph of your eyes we offer a scan of the deeper retinal layers, using our Optical Coherence Tomographer (OCT) scanner. Being one of the first practices or hospitals to have this equipment in Edinburgh we have been learning more and more of the value of these scans as our experience grows and research continues. The most recent neurological research suggests that OCT measurement of the retinal thickness may offer a fast and effective way to monitor progression of Multiple Sclerosis (MS) The research suggests that patients with relapsing MS had rates of retinal thinning up to 42% quicker than those without replases. Perhaps as more therapies are developed to slow MS progression testing retinal thickness will be a useful tool in monitoring how effective these treatments are. As ever, the eye provides a window to the health of the rest of the body. While we use the OCT more commonly to detect and monitor early signs of eye disease, particularly glaucoma and all types of macular degeneration , we also see the value in having these scans done in your healthy eye to establish baseline data that could be invaluable in the future.

The Keratoconus Group is resourcing and self help group for people with keratoconus. Cameron Optometry has long been a supporter and we have often travelled to Glasgow to attend and speak at meetings. With Ian's help an Edinburgh based group was set up and has just had it's second meeting here at the practice. Ian spoke about the latest advances in contact lenses and answered all sorts of questions about keratoconus. They hope to run another meeting on another topic in Spring and we'll keep you updated here. If you are interested in keratoconus or have the condition, you should join the group online at www.keratoconus-group.org.uk

I kid you not, this is the weather in Phoenix. It's hard to beleive it is almost November – I dread to think what it's like here in summer. In fact it's hard to believe it's on the same planet heated by the same sun. Fortunately for my patients (unfortunately for my tan), I've been inside all day in darkened rooms listening to eye lectures. More retinal stuff this morning, but at a much more civilised 10am (I managed to sleep until 7.30 today which means I'm finally getting into Phoenix time with only 2 days left). It was titled ‘Things you don't want to miss' and included some quite scary case histories – always good to stop you being complacent. That was 2 hours long so a break for lunch before more on optic nerves where the focus was on differentiating between glaucoma and other types of optic nerve disease. Interesting and useful but 2 hours felt like 4. To round out the day I spent some time looking at epiretinal membranes (ERM) which are areas of thickening on the retina that can impair vision (kind of like hard skin on the back of the eye). They are quite common and we use the OCT to find see them and monitor them. Many of you will have these in your eyes that we may have told you about. I'm not quite sure we got the whole story about them, the lecturer seemed to miss out some things that I think are quite important when talking about ERM and said some things that I'm not sure are quite 100% correct. Nonetheless, some useful points to bring back. I went to the supermarket for a few bits and bobs and ‘went native' by buying some Twinkies. If you don't know what they are, they are one of the least natural food products you can possibly imagine – however I quite like them and it made me feel very American to buy them. I blended right in with my pasty skin and funny accent… PS. My wife tells me it's snowing in parts of Edinburgh which is frankly impossible to comprehend in this heat.

1 hour to London and then 10 hours to Phoenix. It's a long way to travel but if you are serious about getting access to the best optometry education in the world, it's got to be America and it's got to be the AAO, which this year comes to Phoenix. It's my first time in Phoenix and actually my first time at the AAO. I've been to other American optometry meetings which have been fantastic but already I think the AAO is the best one yet. There are about 5000 optometrists here from all over the world (there are only about 1000 optometrists in the whole of Scotland) and there are 10 streams of lectures every day given you a massive choice of things to listen to. The scale of place is big even by American standards and because of its size, it attracts some real experts in very detailed sub specialities we just don't have in the UK. As you can imagine it is a big investment for a small business when you include time away, travel and accommodation but at CamOpt we are dedicated to being the highest qualified and most experienced optometrists in the UK and that means this is the place we need to come to hear what's new. As always in America early starts are the order of the day so it's 7.15am for a breakfast meeting on contact lenses to get me up and away. No big deal as Phoenix is 8 hours ahead I expect I'll be up at 5am twiddling my thumbs anyway.

Finally some good news for the short sighted as people with long axial lengths (that is the length of the eyeball, front to back) are less likely to suffer from diabetic eye disease. Myopia or shortsightedness is where rays of light are focussed in front (or ‘short') of the retina rather than on it leading to blurry vision. It is easily corrected optically but high myopia can cause many physical problems as the eye is usually larger than normal which causes the focussing short fall – the retina is too far away, if you like. Myopia is described as pathological when you get up to the doubel digits on your prescription and is linked to an increased risk of a form of macular degeneration, glaucoma and retinal detachment. The larger sized eye means the retina is streched thin over a larger area and so is more fragile and prone to damage. This study showed that the longer your eye the less likely you are to have all forms of diabetic retinopathy (mild, moderate, severe). It's rather interesting as it flies in the face of almost every other condition. The authors didn't speculate why they through this might be the case but it will undoubtedly lead to more research as an estimated 1-2 billion people have myopia and 300 million have diabetes worldwide.

A trial of a new method of delivering glaucoma medication by using a slow release punctum plug has started. Glaucoma usually requires patients to permanently take drops once or twice a day to reduce pressure inside the eye. Patients often find it difficult to remember to take the drops or hard to get them int the eye and methods which overcome these issues would be very useful. After an initial small trial in Singapore showed promise, this longer South African trial uses a punctum plug containing the popular glaucoma medication travoprost (Travatan) which is taken in drop form once a day. The plugs will be trialled over a period of 2 months with pressure being monitored regularly for any signs of change. Punctum plugs are normally used for helping treat dry eye by blocking the tear ducts

The risks of swimming with contact lenses are causing a stir in the media following the case of Jennie Hurst. Jennie was featured in the Daily Mail talking about how she lost vision in her left eye after contracting Acanthamoeba keratitis (AK) as the result of swimming in her lenses. AK is a very serious but thankfully very rare infection often related to swimming in contact lenses. As a result, the British Contact Lens Association have updated their advice about swimming in contacts and it's pretty good so I've copied it here: “The BCLA’s advice for contact lens wearers is to not wear contact lenses for swimming – or in hot tubs or whilst showering or participating in water sports – unless wearing tight-fitting goggles over the top. After swimming – or if lenses are removed and stored whilst swimming – contact lenses should be cleaned and disinfected in fresh solution before putting them back on the eyes. The BCLA recommendation is that regular swimmers talk to their eyecare practitioner about being fitted with daily disposable lenses for use with goggles whilst swimming. Wearers of daily disposable contact lenses should always discard them immediately after swimming.” Daily disposables are a great idea for swimming and are available so prescriptions between about +8.00 to -12.00, toric versions for astigmatism and presbyopic versions for folks who need reading glasses. Almost all prescriptions can now be catered for in dailes and having a small supply for swimming/travel as an addition to your regular lenses is a great way of minisming the risks of problems. Call us and we can send you a trial in your prescription.

An Australian group have restored some minimal sight to a patient through an implanted bionic eye. The implant is connected to an external head mounted camera which sends impulses to electrodes planted underneath the retina. The patient was able to see light and dark and some shapes where she had previously seen nothing for many years. There are currently over 10 different bionic eye projects around the world at various stages but no one to date has got much further than providing very rudimentary vision. One of the most advanced is the Argus II model in America.

There has been a breakthrough in the treatment of the previously untreatable form of macular degeneration (‘dry AMD‘). Kentucky vision Scientists have discovered the complex chain reaction of proteins and enzymes that happens in the retina causing dry AMD. They demonstrated that using drugs to selectively block these proteins and enzymes halted the process in various disease models. There has been no trial on humans yet but this gives hope to millions suffering from dry AMD. Usually taken to be the unstoppable ageing process of the retina, dry AMD can get progressively worse with no effective treatment options. This new breakthrough could open up a whole raft of drug therapies to halt or prevent the condition developing.

A big and seemingly well designed study has shown the effect of caffiene on intraocular pressure (IOP). 106 patients split into 4 groups (3 types of glaucoma, 1 no glaucoma) and were seen twice. Before 1 visit they were given caffeine or decaf coffee and then the opposite on the second visit. The study was double blind meaning neither the researchers taking the measurements or the participants knew if they had had the decaf or the fullcaf drink. The results showed that IOP is increased by about 1 unit after caffeine with maximum effect at about 90minutes but the effect is temporary and not very great so needn't concern coffee lovers with glaucoma. Previous studies had put the frighteners on some folks with glaucoma claiming coffee was bad for the condition, but this study will hopefully let them enjoy a cappuccino in peace.