Category: Vision

A contact lens designed to deliver medication gradually to the eye may improve outcomes for patients who struggle with imprecise, difficult to self-administer eye drops.

 (John Earle Photography)

People suffering from glaucoma who find eye drops painful or inconvenient may one day have another option at their disposal: contact lenses that dispense their medication more precisely.

Monday in the journal Ophthalmology, researchers at Harvard University detailed promising results of the device, which dispenses the common glaucoma treatment latanoprost, in four monkeys.

Study authors argued the lenses could improve the estimated 50 percent adherence rate of eye drop use for glaucoma. Although there is no cure for the eye disease, which is the leading cause of irreversible vision loss in the United States, eye drops can help relieve pressure in the eye to help prevent progression. Researchers compared the lenses’ ability to relieve this pressure using a dosage equal to eye drops as well as to that of a higher dose.

"We found that a lower-dose contact lens delivered the same amount of pressure reduction as the latanoprost drops, and a higher-dose lens, interestingly enough, had better pressure reduction than the drops in our small study," first author Dr. Joseph B. Ciolino, an ophthalmologist at Massachusetts Eye and Ear and an assistant professor of ophthalmology at Harvard Medical School, said in a news release. "Based on our preliminary data, the lenses have not only the potential to improve compliance for patients, but also the potential of providing better pressure reduction than the drops."

Unlike previous similar contact lenses that dispensed latanoprost too quickly, the new device dispenses the drug in a more controlled manner, researchers said. In a 2014 study, Ciolino’s team showed their lens could deliver medication continuously for one month, according to the release.

The lens is comprised of a thin film of drug-encapsulated polymers in the periphery. The film slows distribution of the drug, and its placement on the periphery allows clearance of the lens’s center to avoid impacting vision or moisture levels in the eye.

According to the news release, the lens can be designed to be refractive or not, with the ability to correct near- or far-sighted eyes.

Next, study authors plan to study the lenses in humans and to further confirm their findings in the higher-dose lens.

"If we can address the problem of compliance, we may help patients adhere to the therapy necessary to maintain vision in diseases like glaucoma, saving millions from preventable blindness," Ciolino said in the release. "This study also raises the possibility that we may have an option for glaucoma that’s more effective than what we have today."

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Over 2.2 million Americans suffer from glaucoma — now a new procedure may relieve symptoms.

Glaucoma is a disease in which there is a buildup of pressure behind the eye. The pressure often damages the optic nerve and can result in vision loss and blindness if not treated properly.  Most glaucoma patients use eye drops to treat the disease. However, managing the eye drops— which sometimes need to be administered multiple times during the day— can be cumbersome.

"I’m very bad in remembering to take medicine or eye drops. But I do my best," 78-year-old Emad Khaja, who used three different eye drops for his glaucoma, told FoxNews.com.  

One solution for managing the disease is a new minimally invasive surgical procedure that inserts a device called iStent, providing a more permanent solution for glaucoma patients.

"iStent is a novel device that is the latest tool we have to fight glaucoma,” said Dr. Tal Raviv, an ophthalmologist in New York City. “It’s a small stent that’s used to overcome the blockage that’s present in glaucoma,"

iStent is the smallest device to be implanted in the human body and works by opening up the blockage to relieve the pressure. Like stents used in other parts of the body, doctors insert the iStent by visualizing the blockage and bypassing it.

Currently, the iStent procedure is recommended for patients with cataracts and glaucoma. The procedure typically takes an additional ten minutes after the cataract surgery and patients can go home on the same day.

“What’s wonderful about the iStent is because it’s so minimally invasive, the follow-up is no different than a typical cataract surgery follow up,” Raviv said.

In clinical trials, 85 percent of patients who received the iStent were off of the eye drops within a year.

Khaja recently underwent the iStent procedure.

"I can see better and hopefully, as the doctor mentioned, the drops will taper off,” he said.

Medicare and most insurance companies cover the cost of the iStent.

“I think what’s great about the iStent is it’s the first in a whole line of products which is going to fundamentally change the way we treat glaucoma. This is just the first tool we have in this country… we can just bypass the blockage and avoid years of eye drops which have cost and side effects to the patients,” Raviv said.

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It takes remarkable drive and ambition for a young boy from the small east Nepalese village of Olangchungola with no running water or electricity to become one of the leading eye surgeons in Asia. Especially considering this village is a long four-day walk away from the nearest school. But after losing his 17-year-old sister to the tuberculosis, Ruit decided to focus on medicine to so other people’s lives aren’t destroyed by easily preventable and curable diseases.

In the Himalayas, like many other parts of the world, cataracts blindness is considered a natural part aging even though it’s completely preventable.

Dr. Geoffry Tabin is an ophthalmologist and close friend to Ruit. He told FoxNews.com, “cataracts is a clouding of the crystalline lens,” which is a “small lens that focuses light that sits just behind the pretty colored part of the eye called the iris.” In the western world, surgery can easily cure cataracts but those in the third world have to live with it and fall into blindness.

Typically, cataracts surgery involves removing the cloudy lens and replacing it with an artificial one called an intraocular lens. Ruit wanted to bring this procedure to the Himalayas. But, in order to do so the process had to be simplified and made more cost effective. His idea was to remove the expensive technology, make the process manual and somehow lower the cost of the intraocular lenses. To achieve this goal he created the Tilganga Eye Centre – now the Tilganga Institute of Ophthalmology – in 1994, in Kathmandu, Nepal.

“The cost of these intraocular lenses at that time was over 200 dollars and that was almost impossible to provide that to people at the community level,” Ruit told FoxNews.com. Ruit teamed up with ophthalmologist Dr. Fred Hollows to start making the lenses locally in Nepal. The approach worked. Within three years the costs per lens dropped dramatically to just three dollars.

With costs down and the simplification of the procedure, Ruit was able to provide over 100,000 cataract surgeries for just 25 dollars per procedure.

Using his efforts as groundwork, Ruit teamed up with Tabin to create the Himalayan Cataract Project whose aim is to focus on training and developing the infrastructure and techniques to end preventable blindness.

“We’ve been able to bring the amount of blindness in Nepal from 1 per hundred down to .28 percent,” Tabin said. Their efforts and spreading to other parts of Asia and even Africa.

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Cataracts occur as a result of aging of the lens in the eye, and it is a condition that will eventually affect us all. While they tend to be most prevalent in patients aged 50-60, they can develop at any point throughout your life.

We recently got this question for a viewer:

Dear Dr. Manny,

Is there any way that I can prevent cataracts from forming in my eyes?

Thanks,
Terri

While cataracts are treatable, they are not something that you can prevent from happening. There are many different types of cataracts, and some may take decades to form.

Symptoms of cataracts can include loss of vision of any kind, trouble reading, and difficulty driving at night. If left untreated, cataracts can even cause you to go blind.

Once a patient receives a diagnosis, treatment options can include surgery to remove the diseased lens and replace it with a new one. The surgery is performed with a laser to increase accuracy, though patients may still need reading glasses, depending on which replacement lens they choose.

If you begin noticing any of the above symptoms, consult your physician.

Have a health question? Email them to me at DrManny@FoxNews.com.

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Eyeglasses are expensive, yet necessary vision tools for people who wear them. Prices for a complete set of frames and lenses can run hundreds of dollars. Consequently, when a problem with the frames arises, many people prefer to see if they can salvage the glasses, rather than purchase another expensive pair. Repairing the earpiece with glue is a simple method of prolonging the life of a pair of eyeglasses. Be aware that not all damaged earpieces are repairable. An entirely new frame is necessary under some circumstances.

Things You’ll Need

• Eyeglasses
• Strong adhesive glue

• Protective goggles (or other eyewear)
• Toothpick (optional)

Assess the Damage

• Inspect the glasses to determine the damage. If the earpiece is intact, but is no longer attached to the frame (or is loose), skip to Section 2. If the earpiece is broken completely (not just cracked) or is missing, continue to Step 2.

• Contact a retailer of eyeglasses parts to find a suitable earpiece, also know as eyeglasses temple tips, for the current earpiece for the frame.

• Purchase two matching earpieces and replace them both using the procedure below. In the event that the earpiece is damaged and replacement is not possible, try to repair the earpiece using the procedure below as a temporary solution only.

Repair with Glue

• Ensure that affected surfaces on the earpiece and frame are clean and dry. If necessary, wash the earpiece and frame with soap and water and dry thoroughly before starting. Oils or debris from skin can interfere with adhesive bonding.

• Place a drop of glue onto the surface of the area where the frame meets the earpiece, and hold in place for a few seconds while it sets. Be sure not to apply too much glue at once. Doing so may cause the glue to run, making it more difficult to control application. As an optional step, use a toothpick to spread the glue evenly before it sets.

• Repeat Step 2, in order to apply additional layers of adhesive as needed. If the earpiece is cracked, use the glue and toothpicks to fill the crack and remove excess glue.

• Allow bonding to set for at least 30 minutes before attempting to wear the glasses. Using glasses too soon can compromise the adhesive bond.

Tips & Warnings

• When gluing the earpiece, it’s helpful to have a second person available to help with the process. They can hold the frame and earpiece tightly in place as additional layers of glue are added.

• Always wear goggles or other protective eye equipment when using strong adhesives to prevent injury.
• Be sure the area has adequate ventilation when using strong adhesives.

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Jumping eye, or any involuntary eye twitching, is medically referred to as blepharospasm. According to the National Eye Institute, there is not a cure for the condition as of 2010. Bu key causes have been identified, which means that there are treatment options. These involve taking steps to make eye twitching less likely to occur.

• Sleep at least eight hours each night to ensure that you are getting adequate rest. Fatigue is a common cause of jumping eye, and the condition can be avoided by getting more rest. If it is not possible to sleep through the night, try taking naps during the day as well.

• Replace caffeinated beverages with decaffeinated options. Try water with fresh fruit or fruit juice instead. Overconsumption of caffeine is known to trigger the involuntary eye spasms associated with jumping eye.

• Take measures to relieve stress after a particularly tough day. Both anxiety and stress can lead to eye twitching. These measures can include deep breathing, exercising, or listening to upbeat music.

• Break up long periods of staring at a computer screen to avoid straining the eyes. You can rest the eyes by taking a quick nap, sitting with your eyes closed for 15 minutes, or going for a walk which will allow the eyes to focus on other things.

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The three elements of a glasses prescription are the sphere, cylinder and axis. The sphere corrects nearsightedness or farsightedness. The cylinder corrects the amount of astigmatism, and the axis shows where the astigmatism correction is located. A glasses prescription written in minus cylinder form will look very different from the same prescription written in plus cylinder form. However, they will both result in the same vision when they are fitted to the appropriate patient. Transposing glasses prescriptions allows one to change a minus cylinder prescription into a plus cylinder prescription or a plus cylinder prescription into a minus cylinder prescription.

Things You’ll Need

• Pencil
• Paper

• Glasses prescription
• Calculator

Transposing the Glasses Prescription

• Look at the cylinder of the glasses prescription that needs to be transposed. The cylinder is the middle of the three numbers in the glasses prescription. If the sign in front of the cylinder value is a minus, the glasses prescription is in minus cylinder form. If the sign in front of the cylinder value is a plus, the glasses prescription is in plus cylinder form.

• Add the sphere value to the cylinder value. The result will be the new sphere value. This must be done with respect to the plus or minus sign in front of both the sphere and cylinder value. If both values have a minus sign, the new sphere value will be a larger negative number. If one value is a plus sign and the other is a minus sign, the new sphere value will be smaller than the original. The new sphere sign might be either a plus or a minus. If both values have a plus sign, the new sphere value will be a larger positive number.

• Change the sign in front of the cylinder to the opposite of what it was originally. A glasses prescription that originally had a plus in front of the cylinder will now have a minus. One that originally had a minus in front of the cylinder will now have a plus.

• Add 90 degrees to or subtract 90 degrees from the axis value. The axis value must fall between 0 and 180. If the original axis value is 30, 90 degrees would be added to make the new axis value 120. If the original axis value is 100, 90 degrees would be subtracted to make the new axis value 10.

Tips & Warnings

• Using a calculator may be helpful when adding positive and negative numbers.
• Calculators are useful when adding or subtracting ninety degrees to or from the axis.
• Double-check each transposed prescription to ensure that it is accurate.

• Making a mistake while transposing a glasses prescription will result in someone receiving an incorrect glasses prescription.

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Progressive lenses are the latest alternative to bifocals or trifocals. Instead of dividing the lens into discrete sections, they provide a gradual change in magnification power over the area of the lens. This allows users to see at long, intermediate and short distances without changing or removing their glasses. However, there is a trade-off. Because of their design, users often experience blurry or double vision and have trouble adjusting to progressive lenses.

Peripheral Vision Loss

• Progressive lenses cause users to lose peripheral vision. The edges of the lens appear blurred, and users must move their head from side to side to read a newspaper or the content of a computer screen. This causes some to stop wearing progressive lenses altogether.

Incorrect Fitting

• For progressive lenses to work correctly, they must be carefully adjusted to the wearer’s eyes. The lenses are designed to adapt to the movement of the pupil for long and short distance viewing. If the measurement of the mounting points is not accurate, double vision and discomfort will increase.

Small Lenses

• According to lens manufacturer BBGR, the minimum height between the center of the pupil and the bottom of the frame is 18 millimeters. The fashion demand for smaller lenses makes it harder for wearers to adapt to progressive lenses.

Distortion

• Progressive lenses may cause wearers to have double vision, which distorts the shapes of objects and makes them look blurry. The stronger the magnification power of the lenses, the stronger the distortion. If wearers use progressive lenses from the beginning and increase the addition power of the lenses gradually, their adaptation will improve.

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