Tag Archives: health

Monitoring the Progression of Age Related Macular Degeneration

Technology for monitoring those at risk for the progression to Wet AMD

Those with age-related AMD are familiar with the Amsler Grid.  The grid is a cheap and easy,

A normal appearing grid

method of self monitoring for changes in vision related to the central vision.   The grid is usually given to those patients with macular changes by their examining eye doctor.  Traditionally, it is a piece of paper or card with the grid printed on it.  The grid is held at 10 inches from the eye (the other eye is closed) and observe: are there any broken lines, missing squares, doubling of the lines, wavy lines?  The appearance of the grid should be consistent from day to day.

Dry AMD can be a slow,  progressive decline in vision. The

Grid appears distorted

intent is to keep the patient alert to the status of their vision. It is very common for people to be unaware of changes to vision, especially for those with dry AMD.

There is another category of AMD referred to as ‘wet’ AMD.  This is a much faster, progressing sight-threatening stage of AMD.  About 10% to 15% of those with dry AMD will progress to wet AMD.  If you have been identified by your eye care doctor as someone who is at risk for wet AMD, there is a technology designed to monitor and identify the onset of wet  AMD sooner.  The sooner, the better.  The sooner treatment has begun, the more sight can be saved.

The devise is called ForeseeHome by Notal Vision.  It is a table top monitoring device to be

ForeseeHome tabletop monitor

used daily . The test takes about 3 minutes per eye.  The test results are sent to Notal Vision.  If changes are detected, Notal Vision notifies you eye care doctor.  The plan is for  your doctor’s office to call to make an appointment for you to see the doctor.  In this way you can receive prompt treatment to preserve your vision.

How to get hooked up with this system:

First, you must be identified by your doctor as being at risk for developing wet AMD.  It is also the first step to getting help through insurance to get coverage for the system.

ForeseeHome test screen

Follow this link for doctors in your area who participate in this Notal  Vision program: Find a Doctor 

The set up is quite easy.  You do not need a computer or even wifi.  The Notal company has a phone number to help you get set up.

To see a video on how it works, follow this link:  ForeseeHome video

AMD, Genetic Testing, and Supplements

Personalized Medicine, One Size Does Not Fit All

Personalized medicine  identifies an individual’s risk for a disease, like macular degeneration, to help health care providers  tailor  management and treatment to reduce the risk of development and/or progression of the disease. What is good medicine for one person may not be so good for another. Genetic testing is the first step to personalized medicine.

Studies for tImage result for dna genetic materialhe treatment of macular degeneration have yeilded a lot of data on AMD and its progression.  Chief among the studies was the Age-Related Eye Disease Study (AREDS) which looked at the affect of vitamin supplementation for those at risk for age related macular degeneration (AMD) and those who had varying degrees of AMD. What they found is that some individuals responded well to vitamin supplementation and others did not respond as well.  Many groups of researchers have analyzed the data generated by the AREDS and its follow-up study AREDS 2.  The predictor of who goes on  AMD progression or wet AMD depends on 3 factors:

  • Current level of AMD,
  • Genetic Factors, and
  • Non-genetic factors (environmental, like general health, smokers, age, and education.)

There are presently two genetic tests available for macular degeneration : Macula Test PGX and Vita Test (Artic) .  These tests look at genetic markers on known AMD associated genes. The most significant finding, for why some did not do well with the AREDS supplement formula (13%), was a particular genetic profile that resulted in AMD progression, notably because of the zinc in the formula.  Genetic testing is a guide for those supplements that best helps reduce the risk for progression of the disease.  Armed with this information, an eye doctor would recommend the patient not take the AREDS formula with zinc.  This is personalized medicine.  Giving everyone the AREDS vitamin supplement does not benefit everyone the same.  Other genetic profiles do very well with the supplement.    Related image

While routine genetic testing is not  the standard of care at this time, it is an option.  Without genetic testing, doctors and patients do well by managing treatment and controlling health factors to decrease the progression of AMD.  A t this time, both of these genetic tests may not be covered by insurance plans. and must be ordered through your eye care provider.

 

 

 

For the Mind, Body, and Eyes

We are living longer than our ancestors did less than one hundred years ago.  Diseases associated with old age in the past were rare, like cognitive impairments, cardiovascular disease, and some types of cancer, but are now more common in an aging population.  It can also be said that macular degeneration is on the rise because of the increase number of those living to be older.

Normal retina: central macula and optic nerve

It is not known yet how the eyes of the younger generation will fair after decades of chronic blue light exposure emitted from technology.  Medical professionals question their risk for retinal damage and macular degeneration.

So as the population ages, what can be done to decrease the risk for age-related eye diseases?  What can the individual do to help themselves to maintain good ocular health?

“Food be thy medicine and medicine be thy food.” Hippocrates

Macular degeneration with drusen

Ideally, our doctors would like to know that their patients are eating healthy and nutritious foods for both ocular and general medical health.  What the famous AREDS (age-related eye disease study) studies showed us is that nutrition makes a difference.  In the case of this study, the improvements were modest but improvements nonetheless.

Eating healthful foods with adequate

Diabetic retinopathy with hemorrhages

nutritional proportions is not always easy It is the rare individual who spends time evaluating the quality and nutritional benefits of the foods they eat each day.  What we eat is limited by time of year, geography, preferences, and availability.  That is where supplements come in.  Not everyone eats fish (for omega 3s) or likes leafy green vegetables.  What you need to do is to look at what may be missing in your diet.  Talk to a dietitian or a naturopath.

Adequate nutrition with supplementation serves us 3 ways:

  1. optimize your vision and physical health,
  2. disease prevention, and
  3. reduce progression of macular disease.

Lifestyle changes

The concept of movement as exercise is nothing new.  Many athletic types have made lots of money showing us how to exercise.  TV doctors and talk show hosts all expound on the benefits of exercise.  It does make a difference both for eye health and general health.  Many health problems such as  high blood pressure, diabetes, and high cholesterol are linked to eye disease.  What is good for the body is good for the eyes.

Here is how it helps the eyes.

Exercise increases blood flow, resulting in more blood perfusion to the eye.  This can help reduce the risk for glaucoma and increase oxygen and nutrients to a macula which may be degenerating.  Those suffering from diabetes are encouraged to exercise to control blood sugar, which in turn helps to reduce the risk for diabetic retinopathy.

Stop Smoking!

Here we go…another reason to stop smoking.  Quitting smoking reduces your risk for some eye diseases.  Those who smoke are more likely to develop cataracts at an earlier age.  It is known that smoking effects blood vessel function, and anything that effects blood flow will impact the very tiny blood vessels that feed the very sensitive macula.  Smoking increases the risk of macular degeneration.

UV Protection 

Cortical cataracts

We apply onscreen lotions with SPF (sun protection factors) to prevent sunburns to the skin.  Think of sunglasses as SPF for the eyes.  Good quality sunglass lenses will protect against 100% of the tissue damaging ultra violet rays.  Bigger lenses are better, not only to protect the lens and retina of the eye, but also protects the delicate tissues around the eyes.

Studies have shown that chronic, long-term  UV light exposure can cause early

Non -cancerous conjunctival growth: pinguecula

onset of cataracts and macular degeneration later in life.  Exposure of the conjunctiva (whites of the eyes)and eyelids can result in growths and worst yet…cancers.

Visible light spectrum

The Blue Light Hazard

Both young and old who use technology chronically for long periods of time, as many of us do, need to be aware of the potential for eye damage due to exposure to blue light.  This is not the ultra violet invisible ‘light’, it is the high energy visible blue light.  Eye doctors are concerned that excessive exposure over an extensive period of time to high energy blue light will cause retinal degeneration.

Consider reducing time spent on digital devices.  For those who need to , there are computer screen filters which can be purchased to reduce blue light.  Eye glass lenses are made, which filter out specific wavelengths of blue light, thought to be the most damaging.  You would need to ask your eye doctor or optician for these specialty lenses.

Finally, there is an app for that!  Type in to your browser or app store:. blue light filter for…Apple, Windows, Android, Mac, Chrome, etc.  As a bonus, blue light filters can also help with computer eyestrain and difficulty getting to sleep after an extensive period of computer viewing in the evening.

You only have one set of eyes, take care of them.

 

Eye Vitamins: The Antioxidant, Vitamin C

While vitamin C is one of many antioxidants, it is a nutrient that is important to many biochemical reactions in the body and is essential for overall health and is considered to have an anti-aging effect.  It is an essential antioxidant which scavenges for those free radicals produced by the body’s metabolic activity and environmental  attacks to reduce oxidative stress. It is crucial for cardiovascular health, supports the immune system, and nerve cell function. Continue reading Eye Vitamins: The Antioxidant, Vitamin C

Low Vision and Eye Vitamins

Those diagnosed with degenerative, hereditary, and progressive eye disease are looking for something or anything to help slow or halt the progression of their disease. Since the Age-Related Eye Disease Study (AREDS) there has been an increase in the number of supplements labeled as “eye vitamins.” Interestingly, there are many different combinations of supplements. Some are labeled AREDS 2, indicating that the formula is similar to the study formula, others are labeled more obscurely like: Eye vitamins Plus, Premium, Gold, Maxi, Lutein, etc. If you flip the box over, and get a magnifier, you can read the names of the supplements’ and their dosages.  It is confusing at best. Continue reading Low Vision and Eye Vitamins