• How to Prevent Vision Loss

How to Prevent Vision Loss

Each year, 50,000 Amer­i­cans go blind; near­ly half from eye dis­eases that are treat­able or pre­ventable. The num­ber of Amer­i­cans who are blind or visu­al­ly impaired is expect­ed to dou­ble by 2050, accord­ing to the Nation­al Alliance for Eye and Vision Research. Most of it will be dri­ven by an aging pop­u­la­tion and the grow­ing num­ber of peo­ple with chron­ic con­di­tions that cause vision loss, par­tic­u­lar­ly dia­betes.

Expert Medical Advice and Personal Action Can Prevent Vision Loss

Doc­tors, par­tic­u­lar­ly oph­thal­mol­o­gists and even optometrists need to step up their game in help­ing curb the epi­dem­ic of loss of vision, begin­ning with sharp­en­ing their diag­nos­tic skills. A 2016 study pub­lished in JAMA Oph­thal­mol­o­gy found that oph­thal­mol­o­gists missed age-relat­ed mac­u­lar degen­er­a­tion (AMD) in 25% of eyes exam­ined. AMD is an irre­versible loss of vision that affects 14 mil­lion Amer­i­cans.

In the mean­time, only half of the esti­mat­ed 61 mil­lion Amer­i­cans at high risk for vision loss have annu­al exams. Part of this chal­lenge, accord­ing to a 2016 report from the Nation­al Acad­e­mies of Sci­ences, Engi­neer­ing and Med­i­cine is because insur­ance doesn’t always cov­er pre­ven­tive eye care and glass­es.

Plus, many eye dis­eases don’t show symp­toms in the ear­ly stages, so peo­ple don’t real­ize they have a prob­lem until they have a rea­son to get an eye exam. For exam­ple, glau­co­ma is caused by increased pres­sure in the eye that may take years before a patient notices vision loss.

It’s not like patients are blasé about blind­ness. In 2017, the Wilmer Eye Insti­tute at Johns Hop­kins Uni­ver­si­ty asked 2,044 Amer­i­cans to name the ail­ment they fear most. Loss of eye­sight was the top response!

Patient med­ical his­to­ries pro­vide a lot of clues about spe­cif­ic risks for vision loss. A  per­son­al or fam­i­ly his­to­ry of dia­betes increas­es the risk of glau­co­ma and eye dis­eases.

Physi­cians should assess if a patient should be test­ed for dia­betes, and review dia­betes con­trol with patients who report it. In addi­tion, just about all patients have an old­er fam­i­ly mem­ber who has had cataract surgery, but prob­a­bly aren’t aware of the con­nec­tion between ultra­vi­o­let rays and cataracts. Explain this con­nec­tion and edu­cate them about which sun­glass­es pro­vide UV pro­tec­tion and which ones don’t.

Ask if patients suf­fer from dry eye and offer solu­tions, includ­ing reduc­ing screen time and adding omega-3 fish oil sup­ple­ments to the diet.

Final­ly, many patients resist a dilat­ed eye exam, par­tic­u­lar­ly if it isn’t cov­ered by their insur­ance. Explain how it detects prob­lems ear­ly, before symp­toms arise, and reduce the chance a patient will suf­fer the loss of vision.

Loss of eyesight

Patients can take a few mod­er­ate behav­ioral changes to boost eye health for them­selves and their fam­i­lies:

  • Adjust the sleep posi­tion. Some stud­ies show that habit­u­al­ly sleep­ing on one side can cause greater pres­sure and wors­en­ing vision loss in the eye fac­ing down­ward.
  • A diet high in Vit­a­min C can reduce the risk for cataracts by one-third. British researchers believe Vit­a­min C from foods like oranges, red pep­pers, straw­ber­ries, and broc­coli helps pre­vent the cloud­ing of the lens that caus­es cataracts. (Sup­ple­ments do not appear to pro­vide these ben­e­fits.)
  • Eat­ing dark, leafy greens like spinach and kale can reduce glau­co­ma risk by about 20% accord­ing to recent research.
  • Send your kids to play out­side. Not only is it bet­ter for their over­all health, but it also takes them away from screens. Researchers at the Uni­ver­si­ty of Cam­bridge report that for every hour chil­dren play out­side in nat­ur­al light with far-away hori­zons, they cut their risk of near-sight­ed­ness by two per­cent.
    • Anoth­er study found that chil­dren ages 7 to 12 who spend more than three hours a day look­ing at a smart­phone devel­op dry eye.

Patients who are already diag­nosed with glau­co­ma need to take med­ica­tions faith­ful­ly and fol­low their doctor’s’ instruc­tions. In addi­tion, they should embrace mod­er­ate exer­cise: a brisk walk for 20 min­utes four times a week can low­er the pres­sure inside the eye, which helps pro­tect the reti­na, accord­ing to the Glau­co­ma Research Foun­da­tion.

Good News For Patients With Eye Diseases

Dis­ease treat­ment can be dif­fi­cult for patients. Fol­low­ing a dai­ly reg­i­men for years is chal­leng­ing for many. Glau­co­ma patients who run out of their pre­scrip­tion eye drops, for exam­ple, may not have suf­fi­cient insur­ance and funds to pay for addi­tion­al drops.

New treat­ments and cut­ting-edge research in treat­ing eye dis­ease will hope­ful­ly pro­vide solu­tions to the ques­tion “how to pre­vent vision loss?”

In 2016, the FDA approved the Argus II “bion­ic eye” which is actu­al­ly a bion­ic reti­nal implant that elec­tri­cal­ly stim­u­lates the reti­na to induce visu­al per­cep­tion in blind indi­vid­u­als with severe to pro­found retini­tis pig­men­tosa. It uses a tiny cam­era attached to glass­es that sends visu­al data to a microchip implant­ed in the eye, which then sends light sig­nals to the brain. While it pro­vides rudi­men­ta­ry vision, patients say even some vision can great­ly improve the qual­i­ty of life for a blind per­son.

It is now being test­ed in peo­ple with mac­u­lar degen­er­a­tion.
The Glau­co­ma Research Foun­da­tion is test­ing the Bimato­prost ring, a thin, 1-mm thick poly­mer ring worn in the eye that slow­ly releas­es med­ica­tion through­out the day. “It’s like drip irri­ga­tion, rather than flood­ing the eye,” says board chair Dr. Andrew Iwach. As for com­fort, most patients in the tri­al have said they stopped notic­ing it after a few days.

Using stem cells to regen­er­ate healthy cells in dis­ease-dam­aged eyes is the holy grail for researchers, par­tic­u­lar­ly for incur­able con­di­tions that dam­age the reti­na, the lay­er of light-sen­si­tive cells at the back of the eye.

In 2017, a Japan­ese man became the first per­son to receive reti­nal stem cells cre­at­ed from donat­ed skin cells, to pre­vent his mac­u­lar degen­er­a­tion from get­ting worse. And in 2018, two British patients who received stem cell reti­nal patch­es cre­at­ed at the Uni­ver­si­ty of Cal­i­for­nia, San­ta Bar­bara, regained some of their vision.

Too many Amer­i­cans skimp on eye health, even as they fear blind­ness more than any oth­er dis­abil­i­ty. Doc­tors, oph­thal­mol­o­gists, and optometrists need to cre­ate strate­gies to encour­age patients to have year­ly eye exams, includ­ing dila­tion exams and take the lead to address the lack of access that bar too many Amer­i­can patients from get­ting pre­ven­tive eye care.

December 16th, 2018|Comments Off on How to Prevent Vision Loss

About the Author:

Born in Connecticut and raised in Upstate New York , Dr. Stetson graduated Cum Laude from Colgate University in New York, and then earned an MD degree with honors at the University of Vermont College of Medicine. He distinguished himself again in residency at the Albany Medical Center, where he obtained the highest percentile in the Ophthalmology Knowledge Assessment Examinations. Dr. Stetson has performed more than 50,000 refractive surgeries and has been on staff at Diamond Vision since 2004, before becoming Medical Director in 2006.

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