Eye care advice

You may not know but I seriously entertained becoming an astronaut. In fact I actually applied to the European Space Agency while I was at university studying optometry. I really wanted to use my optometry skills rather than just be an astronaut so I had in mind to do some research while I was out there. Now that I think about it, I never heard back from them so they must have not recived my applicaiton. Yes, that's what will have happened… In any case it turns out I can combine eyes and space in the US by working for NASA in Houston investigating the effects of space on the eye and trying to eliminate the vision problems associated with space travel such as early onset cataract and UV/radiation related issues. You have to graduate from the Aeorspace Optometry programme in Florida and you don't actually get to go into space. It seems they don't have use for optometrists during space travel unless you have other skills such as Payload Specialist Lawrence J. DeLucas who graduated in Optometry before studying biochemistry. So even my great optometry skills won't get me a seat on the shuttle so I think I'm going to stick it out at CamOpt a while longer and save up for a shot in Richard Branson's commercial space venture.

There were 100,000 more eye exams carried out in Scotland in 2011-12 compared to the year before. The increase from 1.8million to 1.9million exams is positive for Scotland, where other regions are seeing static or declining numbers of patients attending for eye exams. This comes hot on the heels of a study demonstrating that many people think an eye exam is all about glasses. Debbie McGill, operations manager for Optometry Scotland commented “The recent figures demonstrate an increase in awareness of eye health care and the importance of regular checks.  Optometry Scotland is working hard to link eye care and current public health initiatives to help increase awareness even more in the future.”

Click here for our latest information on our blepharitis treatments. It's hard to know how to respond to this one but apparently a 99p jar of honey from Tesco has cured an eight-year misery case of blepharitis. Frank Dougan lost his left eye as a child to a nasty injury and so has been wearing a prosthetic eye ever since – often called a ‘glass eye' although that is neither correct (as they are made of plastic) nor politically correct. Apparently some aspect of the prosthetic eye irritated his eye lids and led to blepharitis that could not be cured by any recognised treatment for over eight years. On holiday, he chanced upon some advice to try honey which is traditionally known for its antibacterial properties (true by the way) which he smeared on and the problems all went away. He now uses the honey regularly and he says he's cured. Far be it from me to rain on Frank's parade but there seems to be a lot of confusion in this story – the bottom line is that if it works then great, but my sense is that the antibacterial properties of honey are probably nothing but a red herring. The most likely explanation for all this is that the prosthesis wasn't fitting all that well, irritated the eyelids and the lovely thick honey acted like engine grease between the two and prevents the discomfort. If you're really keen, read our article on blepharitis which gives some background info about the condition but there is often confusion about blepharitis. It simply means ‘inflammation of the eyelids' which people often take to mean ‘infection'. Now an infection of the eyelids will certainly cause inflammation but the opposite is not necessarily the case. I reckon Mr Dougan had inflamed but not infected, eyelids. But regardless, I wouldn't have recommend honey. There is a medical lubricant called LacriLube which is more commonly used for this kind of heavy duty greasing. And onto prosthetic eyes… We do a quite a lot of prosthetic eyes and they are very interesting and satisfying when they work well. Here's a wee taster of a few I made earlier.

Bausch & Lomb (a contact lens manufacturer) has released some details about people's attitude to eye examinations which makes quite sad reading if you're an optometrist. 63% of people in the survery think that, because they don’t have any symptoms, there is no need to get their eyes tested, while one in three believe that if they can see, their eyesight is fine and another one in three haven't ever had an eye exam or not for at least 3 years. Woe is me Fortunately our patients are of a far superior calibre and know very well that eye exams at CamOpt can reveal all sorts of things not only about your eyes but your general health. Diabetes, high blood pressure, other circulation problems, minor strokes (TIAs), many neurological conditions and much more can all be picked up first in the eye. It's never nice to consider all these things and there is a temptation to think that ignorance is bliss but it's always better to find these things and the earlier you find them the better for treating them. So our advanced equipment and unparalleled clinical experience means not only will we check for cataracts, macular degeneration, glaucoma and 1000s of other eye conditions, we'll also give your eyes a thorough examination for these other problems and help you get treatment faster when you need it.

What a great day. Perhaps it was a combination of it being a Sunday, and the sun shining but the clinic was a bit quiter for everyone. The stats thus far are that of 199 patients in the polyclinic 120 of them were seen in the eye clinic. The slight let up meant an great opportunity to chat to the athletes. Yesterday that included one of the team of only 6 from the Federated states of Micronesia. He explained that there aren't any concrete buildings on the islands let alone an eye care system, so he has a 4 yearly eye test on his visits to Olympic games. A lovely example of what the Olympic movement is all about. I'm all clued up on the details of trap shooting now too and was able to reassure a shooter that he had better than 6/6 vision, which he said gave him real confidence for his event. Also got to one of the ritual athletes welcome ceremonies that happen periodically through the day in this pre-games period. This time the teams in question were Fiji ( hawiian shirt glad) , palestine and St Kitts and Nevis. A mixture of music, dancing and theatre, with a welcome from Tessa Jowell and Johnathon Edwards. Really looking forward to a chance later this week to get up close to team GB at their welcome ceremony in the village. A well timed tea break will be required! Team GB was the answer to your trivia question. 542 athletes over 26 sports, the biggest delegation in over a century. No pressure on the medal tally then!

A smartphone designed by a and for visually impaired people has gone on sale. The system called Georgie (named after the couple's first guide dog) use the latest voice assisted touchscreen technology combined with specially designed apps for tasks like reading small print, sending text messages and catching a bus. “It's exactly the type of digital experience we want to make easily available to people with little or no sight. It is also going to help solve everyday problems for blind people so they can be more confident about navigating the real world and become independent,” said it's designer. The system can come preinstalled on a phone or can be bought for Android phones from the Google Play store. More info here

Don't worry, there are no pictures in this post and the eye in question belongs to a man in Mumbai so no where round here.It sounds like an old wives tales, but this one is actually true. 75 year old PK Krisnamurthy has an irritated and itchy eye for quite a while and visited his local doctor who referred him to an eye hospital where they found a worm swimming around in the jelly of his eye.The doctor teased out a 13cm threadlike parasite and Mr Krisnamurthy seems to be back to normal.Thankfully these things are very rare and even rarer in the UK so don't worry, but come and see us if you're concerned – we're ready for anything

Our full length introduction and explanation of Corneal Crosslinking is available on our website. This relatively new procedure is becoming quite popular and it can be hard to find reliable information about the benefits and limitations of this treatment online. We've been researching it for quite a while and combined with our expertise in keratoconus and related conditions, we've produced a summary for our patients. Click here to read more about it

First there was (and still is) Blephasteam but now there is the catchily named Panasonic Memoto Este ES-SW50. Using heated steam the system helps to open blocked glands around the eyes and eyelids and can help with blepharitis and meibomian gland dysfunction (MGD) which cause tired gritty and dry eyes. Blephasteam is available in the UK and we actually have a trial system if anyone is interested in having a shot, but the Panasonic is only available in Japan for the moment. Shame.

The College of Optometrists has announced some more details about where Gillian will be working during London 2012 games. The details of who is working there are also included – adding to Gillian's 15 minutes of fame. They say the clinic will showcase the best in UK eyecare but regulars at CamOpt will know that we've been showcasing that for years so it's all in a day's work for Gillian. If you're interested, you can follow this link

Some brave souls in America have suggested that the reason women need reading glasses before men is due to the their smaller stature and therefore shorter arms. Many studies have demonstrated women require reading glasses sooner than men even though they have the same focussing ability (or lack of) – a condition that comes to us all called presbyopia. The researchers suggested that this is because women tend to hold things closer than men and went on to pin the blame shorter female arms. It's one of those rare occasions where common sense and science actually meet but I'm not really sure this research really tells us anything useful. However the lead scientist sought to ramp up the importance by saying “These findings could impact global vision care in multiple ways”. Err, steady on.

People with diabetes who eat a lot of fruit are least likely to develop diabetic retinopathy (diabetic eye disease). An unpublished study of nearly 1000 people in Japan with diabetes found that those people that ate about 2 pieces of fruit per day had a 40% lower risk of developing diabetic retinopathy (DR) over an 8 year period than people who ate about 1/2 a piece of fruit a day. The study has yet to be validated and properly published and the researchers say that although eating fruit was linked to a lower risk of DR, they were not able to establish a cause and effect relationship so there may be other factors involved. Notably, all the participants were on a low fat diet so eating fruit may or may not be as effective in people with a high fat diet. In any case if you're diabetic, eating fruit is not only good for you in the traditional ways we know about but seems to have some effect on DR so it's definitely worth a try.

Results of a 2 year study into the long term effects of Corneal Cross Linking (CXL) in people with progressive keratoconus have shown encouraging results. Corneal cross linking has been gaining a reputation as an important treatment for stabilising progressive keratoconus, but as a relatively new treatment, long term results on its effects are scare. This study measured various aspects of vision and shape in 40 eyes over 2 years in patients under 18 with progressive keratconus. Visual acuity both with and without correction in contact lenses of glasses but a significant amount and the prescription or power of the eyes reduced a noticeable amount making correction of the vision easier. Measures of the shape of the cornea also improved over the study with the shape becoming more regular and a reduction of aberrations which are various types of ‘optical interference' that cause haloes, glare and shadowing in keratoconus.

Edinburgh's very own Dr Ashish Agrawal was on Reporting Scotland highlighting the research into limbal stem cells happening at PAEP the Edinburgh Eye Hospital. Stem cells are the great hope for treating corneal blindness, un umbrella term for any condition that causes the cornea to go cloudy blocking vision. A patient with one such condition has been treated with stem cells and her cornea is now remarkably clear. Unfortuantely she still had a cataract so isn't seeing very much, but Dr Agrawal hopes that by removing that cataract, some useful vision can be restored. Read more here

A new application of corneal cross linking (CXL), a treatment previously used for treating keratoconus has been shown to be effective in treating infectious corneal ulcers. Indian specialists initially treated 6 eyes with the procedure before the favourable results prompted them to expand the study to 31 eyes. Initial treatment was with conventional antibiotics but after 2 weeks and where the eye was not healing properly CXL was performed. All except 2 eyes showed a positive response to the crosslinking procedure. Crosslinking is a relatively new procedure where special drops of riboflavin are instilled into the eye and then activated by controlled exposure to UV light. The riboflavin increases the cross linking between the fibres of collagen that make up the cornea strengthening it. It is a little like the process of tanning leather and happens naturally throughout life. In conditions like keratoconus the eye is more fragile and begins to become misshapen and research has shown cross linking can halt the progression of the condition by strengthening the cornea.

A study in Japan has found that caffiene intake can actually boost the production of tears in the eye, releiving symptoms of dry eye. Half the 78 participants received a caffiene pill and the other half a placebo. 45 minutes later their tear volume was measured. The following week, the participants received the opposite pill and the tear volume was measured again. All 78 showed significantly higher tear volume after taking the caffeine pill than the placebo. But don't go quaffing coffee in the hope of treating your dry eye symptoms. Although caffeine increases tear secretion, drinks like coffee and tea can dehydrate you and general dehydration increases dry eye symptoms. Make sure you get your 8 glasses of water a day to keep well hydrated. Dry eye is one of the most eye common conditions in the world with symptoms ranging for mild discomfort to debilitating irritation and reduced vision. There are many treatments available from simple lubricating drops to medications and even blocking up the drainage tubes from the eye (a reversible process called punctal plugging). At CO we are very experienced in all the specialist investigations and treatments for dry eye so if you've had trouble getting the problem sorted, come and see us.

The largest study to date on the genetics of glaucoma has identified 2 genetic variations that are associated with the condition. Over 6000 patients, half of whom had primary open angle glaucoma had their DNA analysed.  Variations were found in 2 genes which may interact with transforming growth factor beta (TGF-beta), a molecule that regulates cell growth and survival throughout the body. Other genetic research into glaucoma have also pointed to a role in glaucoma for TGF-beta. The researchers  hope that by finding the genes responsible for the condition, new genetic based preventions and treatments can be found. Glaucoma is a leading cause of blindness worldwide and affects around 2% of people over 40. If you have a family history or are concerned about the condition make sure you come and see us.

Australian scientists hope to have a prototype bionic eye built and ready to test on humans within the next year. The bionic eye which we've highlighted before gives hope to people suffering from various types of retinal degeneration and works by implanting 98 electrodes (pictured below) into the retina to replace the damaged cells. An image from a tiny spec mounted camera is then relayed onto the electrodes in the retina. The signal is then passed through the optic nerve to the brain to all the person wearing to see the image from the camera. Such complex work needs high-tech equipment and the lab in New South Wales has just spent $2.5mill upgrading their equipment to carry out the delicate research.

People with AMD are at a increased risk of having a stroke, new research has suggested. Following over 12,000 patients over 13 years, the study found that those with any AMD were about 50% more likely to have a stroke than others even adjusting for other factors. New AMD treatments called Anti VEGF drugs like Lucentis and Avastin are thought to increase risk of stroke in themselves but this latest research finds people with AMD are already at an increased risk and treating AMD could potentially increase the risk. There were some limitations with the study and further research is needed.

The leading wet AMD treatment used in the NHS, Lucentis, is under pressure from a cheaper version called Avastin. Both compounds are from the family of AntiVEGF drugs (anti-vascular endothelial growth factor). In wet AMD, the degeneration causes the retina to make tiny new blood vessels in response to damage. These blood vessels are very fragile and break and bleed into the retina causing scarring and eventually vision loss. AntiVEGF drugs stop and even shrink the growth of these new blood vessels preventing the damaging bleeding. Until now Lucentis has been the only approved drug for use in the eye and costs over £700 per injection (used in multiples of 3 injections normally). Avastin is in the same family of drugs and currently used to treat heart conditions. Costing only £60 per injection, many specialists in other countries have been using it ‘off label' in the eye to great effect. Avastin is now being used to treat 50% of AMD cases in the US and there is increasing pressure on the NHS to approve the use of this drug enabling far more access to the sight saving treatment. At Cameron Optometry, we're experts in all forms of macular disease and have the latest OCT technology which is used by specialists to diagnose and monitor the effects of treatment on wet AMD. If you are concerned or have a family history of the condition, come and see us for some expert advice.

The journal Nature has published evidence of blind mice being made to see after receiving a transplant of retinal cells. The mice received an implant of immature retinal rod cells taken from younger mice. After 4-6 weeks they were able to complete a test requiring vision that previously they could only complete by chance. As always, human trials and possible applicaitons in the treatment of eye disease is still many years off but this is the first evidence that retinal cells can be successfully transplanted and connect properly to the visual system into the new host. This research follows on from what we previously reported about mice receiving transplants enabling some light perception. It's unclear how many blind mice had vision restored but reports suggest somewher between 2 and 4. Sorry…

Researchers in Ireland have found that part of the immune system is involved in the development of Age-related macular degeneration (AMD) and by controlling it, could prevent the progression of the disease. Using animal and donor human eyes, the team found that the part of the immune system that initiates the inflammatory response in cells leading to conditions like AMD (the fantastically named ‘inflammasome') could be controlled and doing so prevented the progression of dry AMD to wet AMD. This opens up a whole new avenue of potential treatment options for AMD. Currently dry AMD can be influenced by nutritional supplements whilst wet AMD requires injections of special types of drugs known as anti-VEGF. At cameron optometry, we really know our stuff when it comes to AMD and we have the most advanced macular scanning OCT available to give you the most accurate assessment of your macula particularly if you have a family history of AMD.

A very interesting study using mice has found that intermittent exposure to low levels of oxygen (such as might be found at high altitude) can strengthen retinal nerve cells and prevent glaucoma. The stress of the intermittent low-oxygen levels promoted a protective response called ‘tolerance' which makes the nerve cells less prone to damage. Normal mice with glaucoma lost an average of 30% of nerve cells after 10 weeks with the condition, but the mice that were exposed to the oxygen stress lost only 3% of nerve cells. This research potentially has application in other neurodegenerative conditions such as  Parkinson's and Alzheimer's. Previous research we highlighted on this blog shows an increasing interest the theory of classing glaucoma as a neurodegenerative condition rather than related to decreased blood supply or mechanical pressure as traditionally thought.

A study has shown that minute eye tremor is highly suggestive of Parkinsons and visible even before any other signs of the disease. 112 patients with Parkinson's were tested, including newly diagnosed cases and some not yet on medication, demonstrated tiny rapid eye movements when attempting to look at a target. These movements are so small they could only be seen with specialist equipment but could explain why some people with Parkinson's complain of blurred vision without an obvious cause for this. The same eye tremor was seen in only two of 60 control subjects showing the power of this sign to accurate differentiate those who have the condition from those who don't. Further research is being carried out into how this test could be included as part of a routine eye exam particularly for those with a family history of Parkinson's.

Work is underway on developing a scanning system for the eye which will be able to detect and grade heart disease. For many years, it has been well known that the blood vessels of the eye give an indication of the general health as they are so small and fragile that they show signs of damage much earlier than other parts of the body. Conditions such as diabetes and high blood pressure and other forms of heart disease can all be seen using the high tech equipment we have at Cameron Optometry. The new Daytona scanner just released from Optos is undergoing trials and research to see if a comprehensive and robust grading system can be set up which will help optometrists assess whether someone is at early risk of heart trouble and can be referred much earlier to a GP for treatment – potentially saving lives.