Cataract Surgery Improves Quality of Life When we think of the impact that cataracts have on people, it is pretty easy to identify that vision decline or loss comes mainly from the blurry cloudy vision that cataracts cause, but also the night vision problems from the glare and haloes associated with cataracts. What is much more important than the vision loss itself is the negative impact on patient’s quality of life. Recent research published in Acta Ophthalmologica studied the effect of patient quality before and after having cataract surgery. The researchers compared patients with no known cataracts of the same age, health and lifestyle to those who had cataracts before and after cataract surgery. When compared with the general population, cataract patients had much lower health-related quality of life (HRQoL) than those without cataracts as measured by five dimensions: seeing, moving, hearing, performing their usual activities and general discomfort and symptoms. Then at 12 months after cataract surgery there was significant improvement in the quality of life index (HRQoL) across these same dimensions. While this seems obvious, it is a reminder that cataracts and vision loss affect more than just vision and reason to avoid suffering if you feel that your vision might be impacting your quality of life.
Treatment of Amblyopia The best results are always achieved if the treatment of amblyopia is started as early as possible. If necessary, children with refractive errors such as nearsightedness, farsightedness or astigmatism can wear glasses or contact lenses when they are as young as one week old. Children with cataracts or other “amblyogenic” conditions need to be treated promptly in order to minimize the development of amblyopia. One of the most important treatments of amblyopia is correcting the refractive error with consistent use of glasses and/or contact lenses. Other mainstays of amblyopia treatment are to enable as clear an image as possible, for example, by removing a cataract, and forcing the child to use the non dominant eye by patching or blurring the better seeing eye with eye drops. Eye drops are used to “penalize” the good eye and force the use of the weaker or amblyopic eye. We may be able to use eye drops instead of patching when the amblyopia is not very bad or when a child is unable to wear the patch as recommended. For mild to moderate degrees of amblyopia, studies have shown that patching or eye drops may be just about equally effective. Generally, we start to see improvements in vision within weeks of treatment however for optimal results it will be necessary to be patient for many months.
In some cases, treatment for amblyopia isn’t successful and it is difficult to stop treatment but is recommended when there is any real benefit. Children who have amblyopia in one eye and good vision only in their other eye can wear safety glasses and sports goggles to protect the normal eye from injury. As long as the good eye stays healthy, these kids function normally in most aspects of society.
Eye Test for Concussion in Student Athletes An eye test for concussions might be helpful for student athletes playing contact sports who are known to be at risk for head trauma. Up to 3.9 million sports related mild traumatic brain injuries, or concussions, occur annually in the United States, according to the Centers for Disease Control and Prevention, but researchers say that number is likely higher since the CDC only tracks emergency room visits. Experiencing a concussion in a game increases an athlete’s risk for sustaining a second condition in the same season by three times. Other complications include the dangerous second impact syndrome, or other short and long term side effects.
Research on Concussion and Eye Tests Research from the NYU Langone Concussion Center shows that a simple eye test, which can be administered in less than two minutes, can effectively diagnose a concussion and help determine whether a student athlete as young as 5 years old should return to a game. A study published in the Journal of Neuro-Ophthalmology, was conducted on 89 NCAA athletes and a younger group of 243 youth athletes under age 17, and shows how the eye test, known as the King-Devick test, could help minimize the problems that make the diagnosis of concussion difficult in student athletes involved in youth sports. The researchers report that the test can easily be administered on the sidelines by parents and non-health care professionals when athletic trainers and doctors are not available to monitor sidelines at youth sports games.
About the King-Devick Test As part of the King-Devick test, athletes read numbers off of three pieces of paper while being timed with a stopwatch. A worsened performance from a baseline reading suggests a concussion has occurred. Since concussions may cause devastating short and long term cognitive effects, tools like vision testing that can objectively diagnose a concussion are critical. Some sideline tests only measure cognition and balance, but visual testing is rarely performed, despite longstanding evidence that vision is commonly affected by concussion, according to a review article published in the Journal of Neuro-Ophthalmology. Previous research suggests about 50 percent of the brain’s pathways are tied to vision.
About Medications and Eye Problems Did you know that a number of medications for various health problems can cause eye problems? If you get any new prescription filled you should be aware of whether it can have any eye or vision side effects by itself or in combination with other medications-prescribed, or even over the counter (OTC) or even supplements you might purchase. Medications can have a variety of effects on your eyes, ranging from minor, temporary issues such as blurred vision to permanent damage. Here are some things to know about medications and your eyes.
Which Drugs Pose the Most Risk? Some medications that stand out when it comes to causing eye and vision problems include: Corticosteroids-People take steroids for a range of conditions, from asthma and allergies to arthritis and skin conditions. But whether in cream or pill form, steroids can cause swelling in the back of the eye or retina and potentially even lead to cataracts. Even an over the counter spray for allergies such as Flonase® comes with risks.
Antihistamines-They may fight allergies, but they also can raise certain patients’ risk for glaucoma. Even over the counter antihistamines can be trouble for those who are at risk for some types of glaucoma.
Mental Health Medications-Medications such as Thorazine and Mellaril, used as antipsychotic treatments, can be toxic to your retina. A number of antidepressants such as Prozac, Paxil, Celexa and Tofranil may put certain individuals at risk for angle closure glaucoma.
Anti-Malaria & Anti-Arthritic Medications-Medications such as Chloroquine, under the brand name Plaquenil, which is used to treat malaria but also Lupus and some forms of arthritis can have toxic effects on the retina.
What to Watch For with New Medications If you get a new prescription or even start a new OTC medication, be aware of anything that causes pain to the eyes, or distorted or blurred vision. If you do experience a problem, talk to the doctor who prescribed the medication. Don’t stop the medication without your doctor’s advice. They’ll want to assess whether the medication is the likely culprit-and sometimes the benefits outweigh the side effects. Always read the warning labels, too- especially if you have a condition such as glaucoma or diabetes. A variety of medications have warnings that patients with glaucoma shouldn’t take them.
There are many other drugs that can have eye side effects and may increase your risk of complications if you need eye surgery. During your eye exam, be sure to ALWAYS tell us if you are taking ANY medications whether prescribed or purchased over the counter (OTC) as well as any supplements of vitamins you are taking. Also, if you or someone you know is taking any medication with known side effects as listed above, or is at risk for glaucoma or has diabetes, it is important to schedule a routine eye exam. Please call Northwest Indiana Eye & Laser Center at 219-464-8223, or visit Northwest Indiana Eye & Laser Center, Google+ or facebook.com/nwindianaeyeandlaser.
Northwest Indiana Eye & Laser Center offices are located at 502 Marquette Street, Valparaiso, Indiana 46383 and 1001 South Edgewood Drive, Knox, Indiana 46354.
We now know that certain eye tests may help serve as “biomarkers” for the progression of Huntington’s Disease as well as help understand whether some of the new medications prescribed might be helping to slow its progress. Huntington's Disease is an inherited disease that causes the progressive breakdown and degeneration of nerve cells in the brain. Huntington's disease has a broad impact on a person's functional abilities and usually results in movement, thinking and psychiatric disorders. Most people with Huntington's Disease develop signs and symptoms in their 30s or 40s, but the onset of disease may be earlier or later in life. Medications are available to help manage the symptoms of Huntington's Disease, but treatments can't prevent the physical, mental and behavioral decline associated with the condition.
Eye Problems with Huntington’s Disease
One of the earliest and most recognizable eye problems of Huntington’s Disease is a change in eye movements or “saccades” where there is a lag initiating an eye movement to look at something and/or an involuntary reflex saccadic movement that the person can’t control. This loss of eye movement control is quite common. Recent research using Optical Coherence Tomography (OCT) testing that we do right in our offices allows us to study the health of the retinal nerve fiber layer and the health of the nerve fibers around the center of vision, called the macula. What we know is the thinning of the nerve fiber layer on OCT, along with a loss of the macular volume is an indicator of the progression of the disease and can serve to monitor that progression.
Lazy Eye Amblyopia: What is it? Amblyopia or “lazy eye” is a very common vision problem that we see in children. In fact it is responsible for more vision loss in kids than all other reasons combined. Amblyopia is a decrease in the child’s vision that occurs even without any structural problem being present. The decrease in vision results when one or both eyes send a blurry image to the brain. The brain then “learns” to only see blurry with that eye, even when glasses are used. Only children can get amblyopia. If it is not treated, it can cause permanent loss of vision. There are a number of types of amblyopia including strabismic amblyopia which is caused by an eye alignment or eye turning problem, deprivation amblyopia which is caused by cataracts or other condition that “deprives” the eye of a visual image and refractive amblyopia which is due to an uncorrected refractive error such as farsightedness or astigmatism.
Depending on the cause of the amblyopia and whether there is an underlying uncorrected refractive error sometime glasses can help but will not correct the vision to 20/20. With amblyopia, the brain is “used to” seeing a blurry image and it cannot interpret the clear image that the glasses produce. With time, however, the brain may “re-learn” how to see and the vision may increase. Remember, glasses alone do not increase the vision all the way to 20/20, as the brain is used to seeing blurry with that eye. Because of this most of the time the normal eye is treated with patching or eye drops to force the amblyopic eye to be used and make it “stronger.” to make the amblyopic (weak) eye stronger.
“I had lasik a couple of months ago and couldn’t be happier. I am a truck driver so my schedule is all over the place. I was excited to hear that the healing time was minimal and i could return to work relatively quickly. I was nervous about my vision during nighttime driving. At first it was a little difficult to due to glare from oncoming headlights but after a few weeks that went away and is no longer a problem for me. One of the best things I have ever done!”