Healthy Vision Month: Eyes on Health

Photo: A pair of eye glasses resting on an eye chart

By: Shanida Ingalla, O.D., WBRC Optometrist

May is Healthy Vision Month.  People who have already experienced vision loss due to eye disease often ask me “Do I still need to get an annual eye exam?”  In a word, Yes!

A nationwide survey commissioned by Lighthouse International showed that only a small minority of those most at risk get the yearly eye exams that could detect a vision problem and prevent, delay or even reverse its progression. Fully 86 percent of those who already have an eye disease do not get routine exams, the telephone survey of 1,004 adults revealed.

Even after being diagnosed, it is still important to monitor your eye health for changes.  It is also equally vital to continue to be screened for other potential eye diseases.  An annual eye exam is your opportunity to learn from your eye doctor if there have been any recent advances in treatments or rehabilitation that may benefit you.

It is often said that the eyes are the window to the soul.  Certainly the eyes are a window to the body, and a proper eye exam can often alert your doctor to a serious underlying disease like diabetes, hypertension, cancer, cardiovascular disease, and multiple sclerosis.

So if it has been a while since your last eye exam, please call your eye doctor and schedule one today!

CLICK HERE to learn more about the WBRC

CLICK HERE to learn more about VIST Services

CLICK HERE to learn more about Healthy Vision Month
 

 

November is National Diabetes Awareness Month

November is National Diabetes Awareness Month.  Diabetes is a group of diseases marked by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Diabetes can lead to serious complications and premature death, but people with diabetes can take steps to control the disease and lower the risk of complications.  25.8 million Americans have diabetes — 8.3 percent of the U.S. population. Of these, 7 million do not know they have the disease.  In 2010, about 1.9 million people ages 20 or older were diagnosed with diabetes.*

Diabetic eye disease refers to a group of eye problems that people with diabetes may face as a complication of diabetes. All can cause severe vision loss or even blindness.  Diabetic eye disease may include:

• Diabetic Retinopathy—damage to the blood vessels in the retina.
• Cataract—clouding of the eye's lens. Cataracts develop at an earlier age in people with diabetes.
• Glaucoma—increase in fluid pressure inside the eye that leads to optic nerve damage and loss of vision. A person with diabetes is nearly twice as likely to get glaucoma as other adults. 

Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in American adults. It is caused by changes in the blood vessels of the retina.  In some people with diabetic retinopathy, blood vessels may swell and leak fluid. In other people, abnormal new blood vessels grow on the surface of the retina. The retina is the light-sensitive tissue at the back of the eye. A healthy retina is necessary for good vision.  If you have diabetic retinopathy, at first you may not notice changes to your vision. But over time, diabetic retinopathy can get worse and cause vision loss. Diabetic retinopathy usually affects both eyes.

Photo: Two boys playing as seen by someone with unaffected vision

Photo: The same image as seen by someone with Diabetic Retinopathy

Blood vessels damaged from diabetic retinopathy can cause vision loss in two ways:

1. Fragile, abnormal blood vessels can develop and leak blood into the center of the eye, blurring vision. This is proliferative retinopathy and is the fourth and most advanced stage of the disease.
2. Fluid can leak into the center of the macula, the part of the eye where sharp, straight-ahead vision occurs. The fluid makes the macula swell, blurring vision. This condition is called macular edema. It can occur at any stage of diabetic retinopathy, although it is more likely to occur as the disease progresses. About half of the people with proliferative retinopathy also have macular edema. 

All people with diabetes--both type 1 and type 2--are at risk to develop diabetic retinopathy. That's why everyone with diabetes should get a comprehensive dilated eye exam at least once a year. The longer someone has diabetes, the more likely he or she will get diabetic retinopathy. Between 40 to 45 percent of Americans diagnosed with diabetes have some stage of diabetic retinopathy. If you have diabetic retinopathy, your doctor can recommend treatment to help prevent its progression.

If you have diabetes get a comprehensive dilated eye exam at least once a year and remember:

• Proliferative retinopathy can develop without symptoms. At this advanced stage, you are at high risk for vision loss.
• Macular edema can develop without symptoms at any of the four stages of diabetic retinopathy.
• You can develop both proliferative retinopathy and macular edema and still see fine. However, you are at high risk for vision loss.
• Your eye care professional can tell if you have macular edema or any stage of diabetic retinopathy. Whether or not you have symptoms, early detection and timely treatment can prevent vision loss.

If you have diabetic retinopathy, you may need an eye exam more often. People with proliferative retinopathy can reduce their risk of blindness by 95 percent with timely treatment and appropriate follow-up care.  The Diabetes Control and Complications Trial (DCCT) showed that better control of blood sugar levels slows the onset and progression of retinopathy. The people with diabetes who kept their blood sugar levels as close to normal as possible also had much less kidney and nerve disease.  This level of blood sugar control may not be best for everyone, including some elderly patients, children under age 13, or people with heart disease. Be sure to ask your doctor if such a control program is right for you.  Other studies have shown that controlling elevated blood pressure and cholesterol can reduce the risk of vision loss. Controlling these will help your overall health as well as help protect your vision.**

*Information gathered from the National Diabetes Education Program
CLICK HERE to read the Diabetes Snapshot from the National Diabetes Education Program
 
**Information gathered from the National Eye Institute
CLICK HERE to learn more about Diabetic Retinopathy from the National Eye Institute

January is National Glaucoma Awareness Month

January is National Glaucoma Awareness Month.  Glaucoma is a group of eye diseases that gradually cause vision loss without warning.  Although the most common forms primarily affect the middle-aged and the elderly, glaucoma can affect people of all ages.  There are two main types of glaucoma: primary open-angle glaucoma (POAG), and angle-closure glaucoma.  These are marked by an increase of intraocular pressure (IOP), or pressure inside the eye which can damage the optic nerve.  This nerve acts like an electric cable with over a million wires and is responsible for carrying images from the eye to the brain. 

Photo: A scene with two children viewed with unimpaired vision

Glaucoma is the second leading cause of blindness in the world, according to the World Health Organization.  In the most common form, there are virtually no symptoms.  Vision loss begins with peripheral or side vision, so if you have glaucoma, you may not notice anything until significant vision is lost. 

Photo: A scene with two children viewed with a Glaucoma simulation

Those at higher risk include people of African, Asian, and Hispanic descent.  Other high-risk groups include: people over 60, family members of those already diagnosed, diabetics, and people who are severely nearsighted.  Regular eye exams are especially important for those at higher risk for glaucoma, and may help to prevent unnecessary vision loss.

The best way to protect your sight from glaucoma is to get a comprehensive eye examination.  Then, if you have glaucoma, treatment can begin immediately. There is no cure for glaucoma—yet.  However, medication or surgery can slow or prevent further vision loss.  The appropriate treatment depends upon the type of glaucoma among other factors. 

Over 2.7 million Americans, and over 60 million people worldwide, have glaucoma.  Experts estimate that half of them don’t know they have it.  If you have glaucoma, or any other type of vision loss, don’t keep it a secret.  Let your family members know and help raise awareness about the importance of regular eye examinations to preserve vision.

CLICK HERE to learn more about Glaucoma

The information above was gathered at www.glaucoma.org

Eyes on Health

By: Shanida Ingalla, O.D., WBRC Optometrist

Photo: A pair of glasses sitting on top of an eye chart

People who have already experienced vision loss due to eye disease often ask me “Do I still need to get an annual eye exam?” In a word, Yes!

A nationwide survey commissioned by Lighthouse International showed that only a small minority of those most at risk get the yearly eye exams that could detect a vision problem and prevent, delay or even reverse its progression. Fully 86 percent of those who already have an eye disease do not get routine exams, the telephone survey of 1,004 adults revealed.

Even after being diagnosed, it is still important to monitor your eye health for changes. It is also equally vital to continue to be screened for other potential eye diseases. An annual eye exam is your opportunity to learn from your eye doctor if there has been any recent advances in treatments or rehabilitation that may benefit you.

It is often said that the eyes are the window to the soul. Certainly the eyes are a window to the body, and a proper eye exam can often alert your doctor to a serious underlying disease like diabetes, hypertension, cancer, cardiovascular disease, and multiple sclerosis.

So if it has been a while since your last eye exam, please call your eye doctor and schedule one today!

VAPAHCS Website Article Reviews Recent Study Connecting TBI and Eye Injuries

VA Palo Alto Health Care System has posted an article on their website regarding a recent study involving veterans with traumatic brain injury (TBI) and resulting vision loss.  The article follows below:


Some Veterans with Traumatic Brain Injury Have Hidden Eye Injuries

Dr. Glen Cockerham examines a patient

'A recent study conducted by the Department of Veterans Affairs (VA) reveals the extent of internal eye injuries (closed-eye ocular injuries) among Veterans who have sustained blast-induced traumatic brain injury (TBI).  Exposure to such blasts is not uncommon in current combat and may result in open injuries to the eyes, which are diagnosed and cared for on scene; however, internal eye injuries are less apparent and may not be detected without more comprehensive examination.

This study, which was conducted from 2006-2009 and is featured in the latest issue of New England Journal of Medicine, evaluated 46 combat Veterans with documented TBI who were injured in Iraq or Afghanistan.  Dr. Glenn Cockerham, one of the lead authors, explains what led to conducting this study. "We started seeing internal eye injuries in a significant percentage of Veterans with TBI due to combat-blast exposure.  In some instances, injuries were not expected by patients."  Twenty of these Veterans, or 43 percent, were found to have internal eye injuries, with no association to TBI severity levels.  Immediate or delayed loss of vision is possible in any of these cases; three Veterans required medical or surgical intervention after examinations.

These injuries were realized only through comprehensive ocular examinations by VA ophthalmologists, prompting VA to implement a 2008 directive mandating such thorough examinations for all inpatients with TBI in rehabilitation centers.  However, many Veterans that were diagnosed with TBI or exposed to blast forces in the past and have returned to civilian life have not received such examinations and may have undetected internal eye injuries.  Most of these injuries – and their related symptoms – go undetected in standard eye exams.  In fact, among Veterans that participated in the study, vision was 20/20 or better in most of the injured eyes.  "The study by Dr. Cockerham and associates clearly shows the importance of comprehensive eye examinations for patients with blast-induced TBI," stated Dr. Mary Lawrence, Deputy Executive Director, Department of Defense/Veterans Affairs Vision Center of Excellence (VCE).

VA is advising physicians of current or former military personnel to inquire about blast exposure, and is encouraging any Veteran who may have been exposed to a blast, even those with normal visual acuity, to be evaluated by an eye care provider.  The study's findings need to be validated in a larger, more representative sample, but underscore the need for immediate ocular screenings for those Veterans who may have been affected.'

CLICK HERE for a Link to the Article posted on the VAPAHCS Website