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News and Articles
- Contact Lens Solution Recall
- Why Do I Need My Eyes Dilated?
- Don’t Lose Sight of Your Diabetes
- Set Your Sight on Macular Degeneration
- No Swimming in Contacts
- Retinal Imaging Technology Available
- Do You Have Computer Related Eyestrain?
Contact Lens Solution Recall: AMO’s Complete Moisture Plus™ Multipurpose Solution
AMO has voluntarily recalled its Complete Moisture Plus™ Multipurpose Solution from the market after data from the CDC suggested that people who use this solution may be at a greater risk of getting a serious eye infection from Acanthamoeba, a water born parasite. Although the risk of getting this type infection is quite low, approximately 1 to 2 per million, people using this solution are advised to discard their current solution, contact lenses and cases.
The best way to minimize your risk of contact lens contamination by any organism is to thoroughly clean your contacts by following the manufacturer’s instructions (we still recommend rubbing and rinsing your lenses, even with “no rub” solutions). Your contact lens case can also be a source of contamination so be sure to discard the solution after inserting your lenses and rinse and air dry your lens case daily. You should replace your case every 3 months. Our doctors do not recommend swimming in contact lenses. For other solution suggestions or if you have any questions you may contact our office. For more information regarding this recall, read the Food and Drug Administration recall notice.
TopWhy Do I Need My Eyes Dilated?: Pupils Are the Windows to the Body
Many people feel that having their pupils dilated during an eye exam is annoying at best. Few people, however, understand why we do it and why it is important to have it done. Lets start by saying that your eye exam is more that just determining the proper eyeglass or contact lens prescription. It is also an opportunity for your doctor to examine the health of your eyes, inside and out.
The external parts of the eye such as the lids, lashes, cornea, conjunctiva and iris are easily viewed under the microscope without the use of eye drops. The internal structures, however, are best examined after the pupils are dilated with eye drops. The reason lies in the understanding that the iris has a circular muscle called a sphincter that constricts the pupil in bright light. Given that we need light to see inside the eye, and that a thorough inspection is difficult through a small pupil, we have to use dilating drops to prevent the iris muscles from constricting and blocking our view. It’s analogous to looking into a gallery through a keyhole in the door. Dilating the pupils opens the door and allows a much better view of the art on the walls. With the pupils dilated the doctor can exam the retina, blood vessels and optic nerve on the inside of the eye. The drops usually take 10-20 minutes to work, and the duration of its effect varies with the type of drug used. Most doctors use drops that wear off in two to four hours. Individual responses will vary as well.
The retina is a very thin sheet of light-sensitive tissue that lines the back wall of the eye. It is the only place in the human body that one can clearly view arteries and veins without skin or bone obstructing the view. The retina is also one of the most metabolically active organs in the human body, and thus requires a rich blood supply. Consequently many cardiovascular conditions like diabetes, high blood pressure, atherosclerosis and stroke can show-up here.
Studies have shown that up to 20% of type 2 (adult-onset) diabetics will have evidence of the disease in their eyes at the time of diagnosis. That means that the changes that your eye doctor sees in the retina can sometimes be the first indication of the disease. Also, patients who have high blood pressure and the presence of micro-vascular changes in the eye are two to four times more likely to have a stroke than those with high blood pressure alone. In chronic conditions like those mentioned above and others, routine monitoring of the retina and its blood supply can provide additional insight to the status of ones condition and/or the adequacy of their management.
The optic nerve is another part of the eye that is meticulously examined. It is the main cable that carries information from the one million or so nerve fibers in the retina to the brain for processing. Glaucoma is the most common condition affecting the optic nerve. It is the second leading cause of blindness in the U.S. affecting over 2 million Americans. It is known as the silent thief of sight because of its ability to cause significant irreversible vision loss with no symptoms until late in the disease. This is a progressive condition that is best diagnosed and managed with routine dilated eye exams. Because the optic nerve’s connections within the brain are expansive, it can also provide clues to other neurologic conditions like brain tumors, diabetes, severe hypertension and stroke.
Although most of the conditions described above usually occur in adults it is still important that children get their eyes dilated as well. Not only do the drops allow a better view to the back parts of the eye, and early diagnosis of disease, but it also relaxes the focusing muscles (which is why it is sometimes hard to focus up close after a dilated exam). Children and young adults especially have the ability to focus at different distances. Excessive focusing during the exam can alter the refraction, or determination of the prescription. Using the drops to temporarily disable the eye’s focusing mechanism (called cycloplegia) allows for a more accurate reading. A cycloplegic refraction is also necessary for anyone undergoing refractive surgery to avoid under or over correction.
As you can see, a dilated eye exam provides you with the most thorough eye health examination possible and allows for the early detection of eye diseases that could mean the difference between seeing and not seeing. Although it can seem like an inconvenience at the time, you and your eyes will be healthier for it.
TopDon’t Lose Sight of Your Diabetes
Nearly 21 million Americans suffer from it. One and a half million people were diagnosed with it last year. An estimated 6 million people in the U.S. don’t know that they have it. What is it? Diabetes: an all too common condition where the body does not adequately produce or properly use insulin. Insulin is a hormone that helps convert sugars into energy. The consequence of elevated sugar levels in the blood stream is damage to small blood vessels throughout the body.
The eye is one place in particular that suffers from the disease. The damaged blood vessels in the back part of the eye, called the retina, can leak and cause hemorrhaging and swelling of the tissue. This is called diabetic retinopathy. Retinopathy does not always produce symptoms, only when the central area of the retina, called the fovea, is affected will the vision be disturbed. In fact, up to 40 percent of newly diagnosed diabetics will have retinopathy at the time they are diagnosed. Most of them are unaware of it. Early detection and careful monitoring is essential. If retinopathy progresses, the retinal blood supply becomes compromised. This can ultimately result in permanent vision loss or even blindness. Although in certain circumstances, treatment with lasers and/or surgery can slow the progression of the disease, it cannot reverse its effects. Anyone with diabetes should get a dilated eye exam at least once a year.
At your first exam as a diabetic, your eye doctor will determine your status and how often you should be seen. The best way to prevent the development or progression of diabetic retinopathy is to eat healthy, exercise regularly, and work with your doctor to control not only your blood sugar, but blood pressure and cholesterol as well.
Two well recognized studies have looked at the level of blood sugar control and the development of diabetes related complications. The first, called the Diabetes Control and Complications Trial (or DCCT) found that tight control of blood sugar levels reduces the risk of developing diabetic retinopathy by 76%, and those who already had evidence of diabetic retinopathy were 54% less likely to have progression of their disease over 5 yrs. Kidney disease was reduced by 50% and nerve disease (diabetic neuropathy) by 60% as well. The other study, called the United Kingdom Prospective Diabetes Study, or UKPDS, looked at tight control of blood sugar levels as well as blood pressure. This study found that tight control of blood pressure reduces the rate of progression of diabetic retinopathy as well as kidney disease, stroke, heart failure and diabetes-related death.
November is American diabetes month, a time to promote public awareness of the disease and the risks associated with it. As a diabetic, however, this awareness must persist day to day, month to month and year to year. With the holidays upon us and visions of sugar-plums dancing in our heads: ‘tis the season to be healthy.
TopSet Your Sight on Macular Degeneration
Age-related Macular Degeneration, AMD or just simply Macular Degeneration is one of the more common diseases of the aging eye. In the United States it affects over 10 million people and is the leading cause of blindness in Americans over 65. The loss of vision associated with this condition can significantly impact someone’s lifestyle and independence. And with the baby-boomers approaching there 6th and 7th decades, the socio-economic burden of this disease is feared by many.
What is Macular Degeneration? Well… as the name implies, it is a condition where the central part of the retina, called the macula, degenerates. The macula is the most sensitive area of the retina and is crucial for things like driving, reading, sewing or any other visual task that requires sharp resolution and detail. The reason that this area is so sensitive is that it is here that the photoreceptors (our rods and cones) are most dense. Like pixels in a camera, the more packed the receptors are in a given area, the greater the resolution.
A consequence of having such a large number of receptors is that it requires a lot of nutritional support to function properly. Much of this comes from a rich blood supply called the choroid and thin layer of cells behind the receptors called the Retinal Pigmented Epithelium or RPE. The RPE cells are responsible for transferring nutrients from the choroid to the receptors and removing any waste products they produce.
It is these RPE cells that are damaged in Macular Degeneration. Without the proper nutrients and waste removal, our receptors get "sick" and slowly die. This process is typically slow and is termed Dry Macular Degeneration. In some circumstances as the condition progresses, the body will try to grow a new blood supply under the retina to compensate for the damaged RPE. These new blood vessels however, are actually more detrimental that beneficial. They tend to leak blood and plasma under the retina and further disrupt the normal retinal architecture.
The development of new blood vessels is called neovascularization and when this occurs, the disease is classified as Neovascular AMD or Wet AMD. Wet AMD can produce a more rapid and significant loss of vision than the dry form. Fortunately, the wet form of macular degeneration is much less common than the dry. But given its devastating effects on vision, it has been the primary focus for treatment. In fact, the few treatments currently available are aimed at controlling and/or eliminating neovascularization. To improve the quality of life for those with vision loss, visual aids such as special glasses and magnifiers can help with things like reading, writing, cooking and other activities.
The exact mechanism of the disease development and progression is not well known; however, certain risk factors have been recognized. It primarily affects those over 60 and is much more prevalent in those with blue eyes, fair skin and a strong family history of the disease as well. People with cardiovascular disease and elevated cholesterol are also at a greater risk.
A diet rich in anti-oxidants may help slow the progression of the disease. One well recognized study has shown that certain vitamin supplements in higher doses can reduce the risk of developing advanced AMD in certain individuals, but one should always consult their doctor before taking supplements. Smoking or a history of smoking significantly increases ones risk for developing AMD. UV light has been associated with AMD as well, thus protecting your eyes with sunglasses year-round is always recommended.
Routine eye exams especially for those over 50, can allow for early detection of the disease. Early detection and intervention can help reduce your chances of losing vision. Talk to your eye doctor about your risk factors and what you can do to maintain healthy eyes for a lifetime.
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No Swimming in Contacts
In case you didn't already know, we do not recommend that anyone swim in their contact lenses. It is a hazard to your health. The bacteria and other micro-organisms that live in the water can stick to your contacts and increase your risk of a serious eye infection. Even chlorinated pools and hot tubs are unsafe. The best way to avoid a problem is to not wear your contacts, but if you're someone who must have correction, then talk to one of our doctors about daily disposable contacts for swimming or recreation. You can wear them once and throw them away.
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Retinal Imaging Technology Available
At Chapel Hill Eyecare, we are committed to providing your eyes with the highest level of care with the most progressive technology available. That's why we've added another diagnostic instrument to our office.
The Optical Coherence Tomography (OCT) is capable of capturing high-quality cross-sectional images of the retina. These scans have a resolution of 10 microns or 1/100th of a millimeter. This instrument can aid in earlier diagnosis and management of glaucoma and retinal diseases such as diabetic retinopathy and macular degeneration.
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Do You Have Computer Related Eyestrain?
Do you spend more than one hour a day on a computer? Do your eyes get tired or irritated in front of a computer monitor? Do you have difficulty finding the right focus with your glasses? Does your neck get sore or tight when trying to use your progressive or bifocal glasses to surf the web or work online? If you answered yes to any of these questions, you could have computer related eyestrain or computer vision syndrome (CVS).
With the increasing number of computers in the home and workplace these days, there is no wondering why more and more people are complaining of computer related vision problems. The good news is that you can do something about it! Taking frequent and short breaks at the computer can help with fatigue. Positioning your computer screen and keyboard to the appropriate heights can head and body posture. Artificial tears can help relieve irritation and dryness. A separate pair of computer glasses is a great way to relax your neck and eyes and will provide optimum correction for the computer screen distance. There are also computer-near progressive lenses that provide correction for reading and the computer. Talk to your doctor about the best options for you.
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