Eye care advice

A recent meta analysis of journal articles has found the prevalence of Age Related Macular Degeneration (AMD) increases 4 times for every decade of age beyond 50. 46 papers from 1950 onwards were analysed by researchers. Due to the differences in the way each of the studies was written, comparison was difficult and among the many interesting details, this key finding emerged: the prevalence of AMD (that is the total number of people with the condition at a given time) increases by a factor of 4 every decade after 50 years old. At 50 the prevalence of AMD is low at 0.04% but rises to an alarming 12% at age 90 making it a leading cause of registrable visual impairment in older adults. These findings highlight the benefit of a thorough examination of the eye. Cameron Optometry is one of a handful of practices in the UK with an OCT (Optical Coherence Tomographer) which is the gold standard testing method of AMD. Combining this with our unparalleled expertise in macular disease means we can give the most reliable and accurate advice regarding treatment options.

Animals and contact lenses aren't a new combination, but and Amsterdam elephant is one of the largest animals ever fitted with a contact lens in Europe. Win Thida suffered a nasty scratch on her cornea and the eye was becoming seriously damaged every time her eyelids rubbed over the open wound. Her keepers tried treating her with artificial tears and lubricating gels but without success. A specialist vet was called in and suggested an supersized contact lens (about 8 times the size of a human one). Insertion wasn't easy and Win Thida had to be slightly sedated but the plan seems to be working. At Cameron Optometry, in humans we do exactly the same thing to treat abrasions. First you see whether simple lubrication will allow the eye to heal but failing that a special bandage contact lens is used to act like a plaster and protect the cornea while it heals. Call us if you think you might need our help.

Novel research in Columbia University has found a new source of insulin secreting cells – intestine cells. People with type 1 diabetes are unable to produce enough insulin which is responsible for breaking down sugar in the bloodstream and too much sugar can cause major problems in the kidneys, heart, teeth and eyes. Until now, diabetics have had to supplement their lack of insulin with regular injections but this research indicates a possible new avenue of home grown treatment. Using gene therapy, the researchers managed to produce insulin in the gut cells of mice. They are hopeful these cells could be grown in the human gut and even respond automatically to heightened levels of insulin.

Glaucoma, long held to be a disease primarily of higher than normal pressure inside the eye, in reality may be a degenerative neurological disease which causes the neural cell death in a similar fashion to Parkinson's or Alzheimer's. In a recent article, specialists presented a view of glaucoma focused on the degeneration of the retinal ganglion cells (RGCs) and their axons in the optic nerve rather than the traditional explanation of a lack of blood supply or mechanical pressure on the fragile nerves. This new thinking could pave the way for a whole new generation of medications for treating glaucoma borrowing research and techniques associated with treating other degenerative neurological conditions.

Sort of… Eighteen months ago over a quarter of a million people applied to be volunteers at the London 2012 Olympics. The numbers were whittled down over a course of interviews and in December Gillian was delighted to accept a post as optometrist for the games. Her duties will involve working as part of a team of health professionals in the polyclinic at the heart Olympic village. She will provide acute eye and contact lens care to the athletes, their teams and spectators and general eye exams to those from developing countries who may not have access to health care at home. Her love of all things sporty, her expertise in contact lenses, and in volunteer optometry abroad make her the ideal choice. She's hoping they might even give her a bit of time off to watch an event or two. She'll keep us updated here as things develop.

Johann Sebastian Bach (1685–1750) composed over 1000 works, sired 20 children and was famously blind. New research in the journal Acta Ophthalmologica suggests the eventual cause of his blindness was severe glaucoma following cataract surgery. Early accounts attributed his failing sight in his mid sixties to overstressing his vision in poor illumination. He was convinced to have cataract couching by a British surgeon (where the cataract is simply pushed into the back chamber of the eye). Although his vision improved initially he was confined to bed by excruciating pain in the eyes and body. He died less than 4 months after this procedure. A common complication of this kind of early surgery is that the eye begins to reject the cataract which has been forced into the back of the eye as foreign material and inflammation takes hold. This in turn can cause a form of glaucoma which can cause severe pain and eventual blindness. Nowadays cataracts are completely removed during surgery and replaced with a man made implant to correct the vision.

The Lancet is reporting on an important new breakthrough in the fight against sight loss. Embryonic stem cell transplants have restored vision to patients registered blind as a result of AMD and Stargardt's macular dystrophy. Two patients in the US and one Briton were operated on as part of a global trial by US biotech firm ‘Advanced Cell Technology' carried out at Moorfields Eye Hospital. Although promising, the researchers said such treatments could still be 10 years away from being available on the NHS.

Israeli-developed spectacles costing around £1,600 per pair are being used to help stroke victims walk again. They work by projecting an image of a tiled black and white floor into the corner of each eyepiece – the images appear to move towards the patient as their body advances prompting the brain to send signals to nerves in the legs and feet.

A new non-invasive laser surgery technique is being developed at King's College London that may delay the onset and development of Age-Related Macular Degeneration (AMD). The technique rejuvenates the thin layer that lies behind the retina called Bruch's membrane which provides nutrients to the retina's light-sensitive cells, improving the removal of waste created as retina cells renew themselves. The procedure can be carried out in 10-15 minutes by and it is suggested that it could be used as a pre-emptive treatment for people in their 30s from families with a history of AMD.

Doctors in Edinburgh and Glasgow have come together to perform groundbreaking surgery to treat corneal blindness using stem cells (where the cornea is unable to transmit light through to the retina making the patient unable to see). The trial led by Prof Bal Dhillon of Edinburgh's Princes Alexandra Eye Pavilion uses the stem cells from dead adult donors rather than embryos and hopes to regenerate the damaged cornea. The trial is currently being carried out on about 20 people.

Scientists in Boston have found a new way to re-grow damaged optic nerves. The finding will give new hope for people who have been left blind and partially sighted by injuries to the cells. The scientists used an innovative technique to ‘knock out' proteins that prevent damaged nerves from regenerating. Like most cells in the central nervous system, once optic nerves are damaged, they don't re-grow but the team at Children's Hospital, Boston have used a protein found in white blood cells which appears to stimulate neuron re-growth after damage.

A new implant could help treat patients suffering from common eye conditions such as glaucoma and age-related macular degeneration. A tiny coil, known as an I-vation is inserted into the back of the eye. Once in place the I-vation slowly releases drugs for a period of up to two years meaning patients no longer need to use regular eye drops or be given eye injections. Early trials of the device have proved effective in the treatment of diabetic macular oedema.

Beryl Haskew who suffers from age related macular degeneration (AMD) has had her vision partially restored using pioneering new surgery to implant a miniature telescope in her eye. Prior to the IOLVIP (intraocular lens for visually-impaired people) procedure – the first of its kind in the UK – Mrs Haskew could not recognise the face of someone stood in front of her but now she is able to read a newspaper. For more information on the IOLVIP, click here

Researchers at Moorfields Eye Hospital and University College London have discovered a way to repair damaged cells in the retina. After trials on rats scientists now hope to develop treatments for conditions such as macular degeneration using regenerative Muller Glial (MG) cells – these cells have the ability to morph themselves into healthy versions of damaged or dying retinal cells. Dormant MG cells cells are found inside the human eye. Trials are now underway to find a way to “kick start” these naturally occurring regenerative cells. In the meantime researchers hope that active MG cells can be nurtured in a lab and transplanted into human eyes.

Material scientists at University of California have created a special contact lens with a bulit-in eye pressure monitoring device. The lens could be worn by glaucoma sufferers to allow accurate and continuous measurement of their eye pressure. The prototype has an opaque sensor but the team are looking at ways of producing a transparent version which would allow the lens to be worn without impairing vision. For more information on glaucoma, click here

Researchers in Australia are using cochlear ear implant technology to develop a bionic eye that could help restore the sight of millions of people who are registered blind. The technology uses electrodes on the outer wall of the eye.  Clinical trials are continuing.

The US Food and Drug Administration (FDA) has convened a special panel to hear from patients following concerns about patient satisfaction with LASIK. The meeting discussed the experiences of patients who had suffered complications from the procedure. The FDA had received 140 complaints of side-effects and device malfunctions between 1998 and 2006 and said it was seeking advice over information currently available to patients considering or undergoing the procedure and whether changes should be made. The agency also confirmed it would conduct a study with the National Eye Institute and other bodies to assess the quality of life of patients after LASIK surgery

Scientists believe that injecting the protein Robo4 into the eye could prevent, and even reverse, symptoms of age-related macular degeneration and diabetic retinopathy. Trials on mice at the University of Utah have proved successful.

Scientists at the Institute of Electrical and Electronics Engineers' international conference on Micro Electro Mechanical Systems have presented for the first time a contact lens-based virtual display. Engineers from the University of Washington used manufacturing techniques at microscopic scales to combine a flexible, biologically safe contact lens with an imprinted electronic circuit and lights. Virtual displays have been proposed for many practical purposes — visual aids to help vision-impaired people, holographic driving control panels and even as a way to surf the Web on the go. “Looking through a completed lens, you would see what the display is generating superimposed on the world outside,” said Babak Parviz, a UW assistant professor of electrical engineering. “This is a very small step toward that goal, but I think it's extremely promising.”

A pill costing just 50 pence a day could prevent diabetic retinopathy, a potentially sight threatening complication of diabetes. Scientists in in Australia have just completed a study involving 10,000 patients aged between 50 and 75. Patients taking the drug, fenofibrate, were found to reduce their risk of needing laser treatment (a normal treatment diabetic eye disease) by a third.  Fenofibrate is a lipid-modifying agent that helps to reduce complications in diabetic retinopathy.  Professor Ian Young from Queen's University, Belfast who lead the study has urged the National Institute for Clinical Excellence (NICE) to recommend using the drug in the NHS.

A simple eye test is being developed to detect early signs of the onset of Alzheimer's disease. The test will look for signs of a build up of the protein beta amyloid in the eye. Neuroptix, the company behind the product say the product uses a special laser to scan the eye and a reciever to monitor the level of protein build-up, a known sign in Alzheimer's sufferers.

Scientists at University College London have discovered a potential link between glaucoma and Alzheimer's. The researchers discovered that the presence of beta-amyloid proteins are key triggers in both conditions. More research is continuing to determine whether glaucoma is an early warning sign of the on-set of Alzheimer's.

Scientists in Israel have developed a pair of high-tech spectacles that can help sufferers of Multiple Sclerosis and Parkinsons walk again. An electronic device fitted to the patient's belt transmits an image of a tiled floor to a projector fitted to a pair of glasses. This floor appears to move, prompting the brain to overcome frozen limb syndrome and make it possible for the patient to walk again.

Cell transplants to restore the sight of blind people could start within a decade, according to researchers who have successfully implanted light-sensitive cells into mice. The first successful transplantation of photoreceptors — the nerve cells which line the back of the eye —marks a major advance in efforts to repair the visual system. The research could have a significant impact on many currently untreatable eye conditions such as age-related macular degeneration and retinitis pigmentosa. Macular degeneration accounts for more blindness in the developed world than all other eye diseases combined. The successful treatment of blind mice comes in the wake of many attempts to repair a damaged retina, notably by the use of stem cells, immature cells capable of developing into other types. Barbara McLaughlan, of the Royal National Institute of the Blind, said: “This is exciting news but it is important not to raise the hopes of people who have lost their sight until the results of human trials become available.”

Chemical engineers at Stanford University have developed a material which they say could be used in the eye as an artificial cornea. The material called “Duoptix” is made of 80% water (a similar proportion to the cornea) and a network of 2 special types of plastic. The researchers hope that it will replace donor tissue in corneal transplant surgery and lower the chance of rejection by the eye which occurs in around 20% of cases. Corneal grafts are carried out in cases where the patient's cornea is either misshapen or loses clarity through disease or injury.