FRAME SHOW - Lafont, October 18, 2014

Uptown EyeCare & Optical is proud to host special styling events every year. Here is a glimpse into our October 18th, 2014 Frame Show featuring Lafont. 

 

9 Worst Eye Care Mistakes You Are Making

You rely on them from the moment you wake up to when you turn off the lights at night. But are you really giving your eyes the care they deserve? We talked to Deeba Chaudri, OD, a New York City-based optometrist about her patients’ biggest bloopers when it comes to taking care of their baby blues (or browns, greens, or hazels).

 

1. Sleeping in Contact Lenses

There are two types of contacts that are FDA-approved for overnight wear, but Chaudri says even those can be risky. In fact, an American Academy of Ophthalmology study revealed that the risk of developing a corneal ulcer is 10 to 15 times greater in extended-wear contact lens users than those who only wear their contacts during the day. And don’t even think about sleeping in any other type of contact lens. “You’re depriving your corneas of oxygen, and that’s a great way to cause infection and encourage bacteria to grow,” Chaudri says. It’s fine to take a 20-minute nap in your contacts, she says, but it’s safer to take them out beforehand—just in case you oversleep! If you do wake up to realize you’re still sporting your lenses, don’t try to take them out right away; if your eyes are dried out, you could actually pull the top layer of your cornea away with them. Instead, wait 20 to 30 minutes and lubricate with artificial tears before you remove the contacts. Then stick to glasses for the rest of the day.

2. Touching and Rubbing Your Eyes

Whether you wear contacts or not, you’re asking for trouble by unnecessary poking and rubbing your eyes. “Sometimes your eyes itch and you have to rub, but it’s best to keep the lid closed and only touch the outside of the eye,” Chaudri says. Rubbing too hard can also lead to broken blood vessels and inflammation. Another reason to keep your hands off? Your eyes are protected by mucous membranes—moist tissue that can easily collect dirt and germs—so they’re a great place for bacteria to grow. “If you shake someone’s hand and then you rub your eyes, you’re transmitting those germs and there’s a good chance you can catch whatever cold he’s got.”

3. Staring at Devices All Day (and Night)

Electronic screens, like those on our computers, tablets, and smartphones, emit blue light, which eye doctors believe to be as harmful as the sun’s ultraviolet rays. Plus, focusing on anything for hours on end can cause eyestrain and headaches, Chaudri says. “If I told you to run around Manhattan and not stop for hours, your calves would be pretty sore afterward, wouldn’t they? Think about what your eyes are going through when you don’t take a break from your computer all day,” she says. Instead, follow the 20-20 rule: For every 20 minutes you look at a screen, take a 20-second break to look into the distance, refocus your eyes on something else, and make a conscious effort to blink—you may not have been doing enough of it before!

4. Applying Eyeliner to Your Waterline

Even though makeup artists often swear by putting liner on the inside of your lower lashes, Chaudri says it’s actually quite risky. “When you put liner inside your eye, you’re mixing it with your tears,” she explains. If you’re wearing contacts, your lenses then get coated in tiny makeup particles, which can deprive your eyes of oxygen. And even if you’re not wearing contacts, those makeup particles can also be carrying germs that can cause infection. Liquid liners are especially dangerous, she adds, since the applicator tip sits in a tube that can harbor bacteria. Soft pencils are safer since they are continuously being worn down and a new “tip” is exposed, but she still recommends applying them outside the eye only.

5. Not Getting Annual Exams

“A lot of first-time patients tell me ‘I haven’t had an eye exam in 12 years because my vision was 20/20 the last time I was checked,'” Chaudri says. Vision changes aren’t even the most important reason you should still see an eye doc every year, she says. “It’s about getting your overall eye health checked out: There are no pain receptors behind the eye, so if you have a broken blood vessel or a tumor back there, you would otherwise not know it until it starts to interfere with your vision, or worse.”

6. Sleeping In Your Make-Up

Hitting the sack without washing your face can do more than leave mascara stains on your pillow; it can also clog the glands around your peepers and lead to irritated skin, pimples, and even styes—painful, raised bumps that can appear on or around the eyelids. False lashes are a no-no in Chaudri’s book, too. “If you’re sleeping in them and rubbing them, that glue can get into your cornea and lead to major inflammation.”

7. Using Expired Solution, Lenses or Drops

There’s nothing wrong with saving a slightly-past-its-prime bottle of contact lens solution, right? Actually, there could be. “These solutions have cleansers that kill bacteria on your lenses, so you want to make sure all of those ingredients are still doing their job,” Chaudri says. The same thing goes for the lenses themselves, which sit in a sterile solution that can break down over time. Artificial tears and prescription eye drops also have expiration dates that you should pay close attention to, as well. And definitely don’t rinse your contact case or store contacts in any liquid that’s not sterile, like tap or distilled water; both have been associated with Acanthamoeba keratitis, a drug-resistant corneal infection.

8. Relying on Redness-Reducing Drops

“My biggest pet peeve is the overuse of redness-reducing eye drops,” Chaudri says. The kinds you buy in the drugstore contain vasoconstrictors, which shrink blood vessels and temporarily make your eyes appear less red. “But they also contain preservatives and other chemicals that can make your problem even worse in the long run, and it’s only a matter of time before you experience a rebound effect.” If your eyes are constantly red or irritated, it’s important to see an eye doctor who can get to the root of your problem, Chaudri says. He or she can recommend an over-the-counter product (like a moisturizing “artificial tears” drop) or suggest other forms of treatment.

9. Not Wearing Sunglasses Year-Round

“A lot of people think sunglasses are only for the summer, or that they’re only for fashion purposes,” Chaudri says. “But wearing them in the winter can be even more important because the sun reflects off the snow.” Failing to wear proper UV protection can result in corneal burns, skin cancer on the eyelids, and visible spots on the whites of the eyes. Make sure your glasses provide protection against UVA and UVB rays, advises Chaudri, and wear them whenever you’re out in the sun.

ABC News August 17, 2014

By Amanda MacMillan (This article originally appeared on Health.com)

Back to School Eye Exams Awareness

Digital takeover: 5 stats that reinforce back-to-school exams

 “Each year when school starts, we see an increase in kids complaining of symptoms synonymous with eye strain.” Summer vacation likely wasn't a break from electronic devices for many kids, but as school gets back in session, it's blue light—not sunlight—that will sparkle in students' eyes. And that's all the more reason for a back-to-school eye exam.

This year's AOA Ready-for-School public awareness campaign has circulated nationwide since July, promoting the necessity of such exams and pairing it with results from recent AOA surveys that show a stark contrast between parents' and kids' perceptions of digital device use.

"Each year when school starts, we see an increase in kids complaining of symptoms synonymous with eye strain," stated Lori Roberts, O.D., chair of the AOA's New Technology Committee, in the campaign. "Essentially, they're going from being home over the summer with a minimal amount of time spent using their devices back to a classroom full of technology, and their time on devices often doubles, leading to a strain on the eyes."

Digital devices take a toll
The Ready-for-School campaign includes materials that give recommendations for avoiding digital eye strain, including the 20-20-20 rule while using screens: Take a 20-second break every 20 minutes and fixate vision on something 20 feet away.

But do parents, and for that matter students, know these recommendations? According to results of the AOA's 2014 American Eye-Q and a children's omnibus survey, the integration of technology into the classroom gives more of a reason for children to get an eye exam, because:

1. Kids are digitally connected longer than parents think. Eighty-three percent of children report using an electronic device more than 3 hours daily, while only 40 percent of parents think their kids exceed that mark; furthermore, 42 percent of kids report 5 hours of use or more versus only 10 percent of parents that think the same thing;
2. All that time can cause eye problems. Eighty percent of children report their eyes have burned, itched, felt tired or had blurry vision after using an electronic device;
3. Kids aren't taking appropriate breaks. Students aren't following the 20-20-20 rule—14 percent report taking a visual break from their device every 20 minutes. A third of kids report taking breaks every few hours or not at all;
4. Most learning happens visually. An estimated 75 to 90 percent of all classroom learning happens through visual pathways—nearly all tasks a child performs depend on good vision;
5. More could be done to get kids in the exam chair. Almost a third of parents report a child should be 3 years or older before visiting the eye doctor for his or her first comprehensive eye exam, while another 28 percent report they don't know when their child should first be seen.

The AOA recommends every child be seen by an optometrist soon after 6 months of age and before the age of 3, and as a result of the pediatric essential health benefit in the Affordable Care Act, children are now covered for yearly comprehensive eye exams through age 18.

Survey Reveals Parents Drastically Underestimate the Time Kids Spend on Electronic Devices

Home and classroom digital device use is up among school-age children; American Optometric Association recommends yearly back-to-school eye exams

According to the American Optometric Association (AOA), parents severely underestimate the time their children spend on digital devices. An AOA survey reports that 83 percent of children between the ages of 10 and 17 estimate they use an electronic device for three or more hours each day. However, a separate AOA survey of parents revealed that only 40 percent of parents believe their children use an electronic device for that same amount of time. Eye doctors are concerned that this significant disparity may indicate that parents are more likely to overlook warning signs and symptoms associated with vision problems due to technology use, such as digital eyestrain.

Eighty percent of children surveyed report experiencing burning, itchy or tired eyes after using electronic devices for long periods of time. These are all symptoms of digital eyestrain, a temporary vision condition caused by prolonged use of technology. Additional symptoms may include headaches, fatigue, loss of focus, blurred vision, double vision or head and neck pain.

"When parents think about their kids' mobile consumption habits, they often don't think about how much time they spend on devices in the classroom," said Lori Roberts, O.D., chair of the AOA's New Technology Committee. "Each year when school starts we see an increase in kids complaining of symptoms synonymous with eye strain. Essentially, they're going from being home over the summer with a minimal amount of time spent using their devices back to a classroom full of technology, and their time on devices often doubles, leading to a strain on the eyes."

Optometrists are also growing increasingly concerned about the kinds of light everyday electronic devices give off - high-energy, short-wavelength blue and violet light - and how those rays might affect and even age the eyes. Today's smartphones, tablets, LED monitors and even flat screen TVs all give off light in this range, as do cool-light compact fluorescent bulbs. Early research shows that overexposure to blue light could contribute to eye strain and discomfort and may lead to serious conditions such as age-related macular degeneration (AMD), which can cause blindness.

When it comes to protecting eyes and vision from digital eyestrain, taking frequent visual breaks is important. Children should make sure they practice the 20-20-20 rule: when using technology or doing near work, take a 20-second break, every 20 minutes and view something 20 feet away. According to the survey, nearly one-third (32 percent) of children go a full hour using technology before they take a visual break instead of every 20 minutes as recommended.

Additionally, children who normally do not require the use of eyeglasses may benefit from glasses prescribed specifically for intermediate distance for computer use. And children who already wear glasses may find their current prescription does not provide optimal vision for viewing a computer screen. An eye doctor can provide recommendations for each individual patient.

The AOA suggests the following guidelines to help prevent or reduce eye and vision problems associated with digital eyestrain:

• Check the height and position of the device. Computer screens should be four to five inches below eye level and 20 to 28 inches away from the eyes. Digital devices should be held a safe distance away from eyes and slightly below eye level.

• Check for glare on the screen. Windows or other light sources should not be directly visible when sitting in front of a computer monitor. If this happens, turn the desk or computer to prevent glare on the screen. Also consider adjusting the brightness of the screen on your digital device or changing its background color.

• Reduce the amount of lighting in the room to match the computer screen. A lower-wattage light can be substituted for a bright overhead light or a dimmer switch may be installed to give flexible control of room lighting.

• Adjust font size. Increase the size of text on the screen of the device to make it easier on your eyes when reading.

• Keep blinking. To minimize the chances of developing dry eye when using a computer or digital device, make an effort to blink frequently. Blinking keeps the front surface of the eye moist.

The AOA recommends every child have an eye exam by an optometrist soon after 6 months of age and before age 3. Children now have the benefit of yearly comprehensive eye exams thanks to the Pediatric Essential Health Benefit in the Affordable Care Act, through age 18.

"Parents should know that vision screenings miss too many children who should be referred to an optometrist for an eye examination to correct vision," added Dr. Roberts. "Eye exams performed by an eye doctor are the only way to diagnose eye and vision diseases and disorders in children. Undiagnosed vision problems can impair learning and can cause vision loss and other issues that significantly impact a child's quality of life."

Vision Walk 2014

On June 28th, 2014, we closed our practice and walked a 5k at Oaks Park for a great cause - to help bring us closer to a cure, because a Cure is in Sight! Our team has raised $630.64 and volunteered our time to save and restore sight to the 10 million Americans living in darkness.  It was great to meet other generous teams and individuals who participated in this event.

Building on more than four decades of research, the Foundation Fighting Blindness is now on the verge of break-troughs that will transform the lives of people living with blinding retinal diseases (Retinitis Pigmentosa (RP), Macular Degeneration, Stargardt Disease, Usher Syndrome and others). Foundation-funded researchers are achieving remarkable success with a wide range of promising therapies for saving and restoring sight. Below are just a few examples of the research that is providing hope to millions affected by inherited retinal diseases.

* Gene therapy Restores Vision: The Foundation is funding clinical trials of gene therapy that have restored vision in patients who were virtually blind from a childhood form of RP. Thanks to treatments, they can now enjoy some of life's simple joys, like reading and paying baseball.

* Re-purposing Approved Drugs to Preserve Vision: Valproid acid, a drug that is FDA-approved to treat epilepsy, has shown promise for preserving vision in people with autosomal dominant forms of RP. The Foundations has launched a human trial to test this drug and, if effective, move it quickly out to patients who need it.

*Harnessing the Power of Stem Cells: Foundation-funded researchers are using stem cells derived from a variety of sources, including a person's own skin, to create healthy retinal cells that can potentially restore vision. Stem cell treatments hold great promise for people with advanced vision loss.

* Funding the Best in Retinal Research: The Foundation has funded studies at hundreds of promising institutions throughout the world.

At Uptown Eyecare & Optical, both Dr. Friberg and Dr. Scheiffele, are well versed in helping to diagnose, prevent and treat retinal diseases.  Both Doctors have a passion for ensuring that all of our patients have the most comprehensive eye care, and believe that the health of each one of your eyes is of the utmost importance.

Enjoy the photos from the fun event: 

 

A big THANK YOU to all these generous financial sponsors: Uptown EyeCare, Dr. Friberg, Dr. Scheiffele, Dr. Loy, Polina, Dave, Deb, Jamie, Johhny, John, Ken, Kimberly, and Sue.

http://www.fightblindness.org/site/TR/VISIONWALK/VisionWalktr?team_id=76227&pg=team&fr_id=5321 

Combating Eye Allergies

March 10, 2014 by coavision
   
It’s that time when we spring ahead and lose one hour of precious sleep.  As we set our clocks forward, we should also keep in mind that spring is literally just a few weeks away.  Many of our trees start branching out and flowers start blooming in magnificent colors.  As an allergy sufferer, I view spring as a time of burgeoning new life on one hand and of the dreaded allergies on the other.

For my patients with known seasonal eye allergies, I pre-treat them with anti-allergy eye drops from a class of medication called mast cell stabilizers.  In an ideal world, I like to initiate the anti-allergy therapy about one month before the time that their allergies would have set in.  Mast cell stabilizers work by preventing the body from releasing histamines from mast cells that cause the itchy, watery, red, puffy irritated eyes.  For those patients that have a new onset of eye allergies, immediate relief is what they are probably looking for so I turn to my combo medications that contain both antihistamines and mast cell stabilizers. Antihistamines as the name denotes, blocks histamines from attaching to key sites and activating the course of allergies.

Here are some helpful tips I share with all my patients:

• Apply cold compresses on top of closed eyelids. This will shrink down blood vessels and limit the circulation of histamines that cause itching and other eye symptoms.
• If you are a contact lens patient, clean your contacts well. You may want to switch to daily disposables to reduce pollen accumulation. Use anti-allergy eye drops that require once a day instillation. Wear glasses if the allergy is bothersome.
• Wash your hair at night to eliminate all the pollen that collected during the day and to prevent coming into contact on the pillow while sleeping.
• If you own a pet, bathe him more frequently to reduce pollen that is stuck on him. Best to keep your pet strictly indoors or outdoors to prevent transporting pollen into the house and on you.
• Avoid drying clothes or bed sheets naturally outdoors as the pollen can adhere to these items.
• Plan outdoor activities early in the morning and late in the evening as the pollen count is the lowest at these times.
• Pick vacation spots that have low pollen counts such as the beach.
• Get your daily pollen forecast on www.pollen.com. See what is floating around in your neighborhood or place of work.

As a “seasoned” (no pun intended) allergy sufferer, I am ready to combat the upcoming 2014 allergy season.  Are you?  Please make sure you plan ahead and make an appointment with your optometrist.

~Judy Tong, OD, FAAO
California Optometric Association
http://eyehelp.org
http://www.coavision.org

FRAME SHOW featuring BEVEL - SAVE THE DATE!

Uptown Eyecare & Optical invites you to an exclusive trunk show & styling event featuring BEVEL,  on Saturday May 3rd, 2014!

More details about the trunk show:
* Saturday May 3rd, 2014,  from 9am - 3pm
* Our ABO-certified opticians will help you with your frame and lens selection
* RSVP for the event on our website
* 25% off a complete pair of glasses on Bevel frames purchases
* Multiple pair discounts: 35% off a complete pair of glasses
* Outside valid prescriptions are welcome and appreciated

What is a trunk show?
Generally speaking, a trunk show is a giant sale. Frame representatives carry their full line of frames in the trunks of their cars as they travel from optical shop to optical shop. The frame purchaser at a particular shop only selects the frames they want to carry in their store.

During a designer trunk show, or frame show,  we invite one or two of the most interesting frame vendors to show their entire line of frames in all colors, sizes and shapes. This is the time of the year we offer our best discounts and our patients have a much larger than normal selection of frames.
We will be serving light refreshments and the whole Uptown EyeCare staff will be all dressed up wearing BEVEL frames! We look forward to seeing you there!

How do I RSVP? 
To RSVP, please go to our website and send us your name and email address as your confirmation that you will be attending the frame show. We will have a special drawing one week prior to the event for those who RSVP for a chance to win 50% off a new pair of BEVEL frames and lenses! RSVP by April 25th 2014  if you would like to be included in the drawing. The winner must have a valid prescription, be present & purchase on the date of the frame show.


Tell me more about BEVEL.. 
Based out of Kansas City, Bevel brings a clean, classic sophistication to our wide collection of eyewear. This line offers phenomenal spectacles that fit people with petite faces, as well as those who need a bigger frame.

Bevel is committed to maintaining a classic but minimalist esthetic, using truly high-quality materials. Form, function and quality are the bedrock of this stunning collection & they are constantly seeking innovation so Bevel glasses look, fit, and perform better.

As one of the very few USA based high end optical companies, Bevel continues to forge it’s own path to success both in the United States and internationally through it’s collection of bold and beautiful eyewear designs.

http://www.bevelspecs.com/

New Transitions Lenses are here!

Transitions Optical developed Transitions® Signature™ VII lenses to be more responsive in more situations by testing them in over 200 real-life conditions representing more than a thousand scenarios combining various temperatures, weather conditions and geographies. Read here to know more about the new and improved Transition VII lenses: 

 

What is Transitions® Signature™ VII and how is it different/better?

Transitions® Signature™ VII is the latest and most balanced photochromic lens from Transitions Optical. Transitions® Signature™ VII is more responsive in more situations, being more reactive to indirect light and darker especially in warmer conditions – while at the same keeping excellent clarity indoors and fast to fade back.

How are Transitions® Signature™ VII lenses different to Transitions® XTRActive™?

Both are clear lens replacements. Transitions® Signature™ VII is our most balanced lens to date having a high degree of indoor clarity and with improved outdoor darkness and responsiveness on hot days. It is available in a broad range of lens designs and materials in Grey and Brown. XTRActive™ goes darker outdoors, darkens moderately behind a car windscreen and has a slight residual tint indoors. It is available in Grey.

What’s new and different about the darkness of Transitions® Signature™ VII lenses?

Transitions® Signature™ VII lenses are darker than Transitions® VI™ lenses in average and hotter temperatures. When measured over 1000 times in 200 different situations Transitions® Signature™ VII Brown lenses were shown to be on average 21% darker than Transitions VI and Grey 15% darker. As the most balanced Transitions lens to date, Transitions® Signature™ VII lenses will provide even more visual comfort, glare reduction and enhanced contrast than any Transitions lens previously available. They are also darker in situations when the wearer is not directly facing the sun, which is key as wearers avoid looking into the sun.

Are Transitions® Signature™ VII lenses compatible with premium anti-reflective coatings?

Absolutely. Transitions® Signature™ VII lenses are compatible with all premium AR coatings and hardcoats.
In fact, Transitions® Signature™ VII lenses are even clearer than regular clear lenses when a premium
AR coating is applied. For added flexibility, if necessary, the hardcoat on Transitions® Signature™ VII l
lenses is easily removed in a laboratory prior to AR or proprietary hardcoat application.

Can Transitions® Signature™ VII lenses be tinted?

Yes, but we do not recommend it as tinting will compromise the clarity of Transitions® Signature™ VII
lenses which are virtually as clear as regular clear lenses indoors and at night. If a pre-tint is required
your patient might choose to consider Transitions Performance Sunwear and Transitions adaptive
sunwear lenses as they are specifically designed for outdoor activities.

Are Transitions® Signature™ VII lenses limited to any particular spectacle frames? 

Absolutely not. That’s one of the benefits of Transitions lenses – they are suitable for virtually any
frame designed for mounting prescription lenses.

In what colours are Transitions® Signature™ VII lenses offered?

Transitions® Signature™ VII lenses are available in Grey or Brown tints. Both tints have been optimised
for better color consistency, providing further improved aesthetics and enhanced vision.

 

February is Age-Related Macular Degeneration and Low Vision Awareness Month

Age-Related Macular Degeneration / Low Vision Awareness Month is sponsored by Prevent Blindness America.

What is Age-related macular degeneration (ARMD)? 
ARMD is a disorder of the macula. The macula is the part of your retina where your central and color vision comes from. ARMD is a complex disorder where degenerative protein/lipids (called “drusen”) deposit under the retina. These deposits are seen in early macular degeneration. As the disease progresses, the structural support system of the retina breaks down and can allow abnormal blood vessels to grow, or leak fluid and further disrupt the retinal cells. If these blood vessels grow in the macula then you will lose your central. (There are other types of macular degeneration and drusen deposits that are not related to ARMD so a complete eye exam by an eye doctor for diagnosis is recommended.)

ARMD is the leading cause of central vision loss in Americans over 50 years old.
There are three main types of age-related macular degeneration:

1. Dry or Nonexudative – drusen and pigment deposits only
2. Wet or Exudative – abnormal growth/leakage of blood vessels +/- drusen deposits
3. Geographic atrophy – retinal support system breaks down with loss of vision without blood vessels or drusen usually

What are the risk factors?

1. Age: Affects more than 2 million Americans over 50 years old. Prevalence of ARMD in the USA is around 6% when 65 and almost 20% when 75 years old.
2. Genetics: Family history (many genes being studied)
3. Smoking: Increases your risk for progression
4. Other eye conditions: hyperopia and light colored iris
5. Systemic diseases associated: hypertension, hypercholesterolemia, cardiovascular disease
6. Gender: women are more likely to be affected than men
7. Race: Caucasian
8. UV light – no significant proven risk but caution and sunglasses advised.

What is the treatment? 
One of the mainstays of treatment of dry AMD are: 1) quitting smoking and 2) taking lutein, zeaxanthin and meso-zeaxanthin supplements.

Depending on your type and severity of macular degeneration, there are many new and exciting treatment options that can not only prevent further vision loss but they can help you regain vision, sometimes even back to 20/20. Discuss your options with your eye doctor.

More information about AMD can be found here: http://www.preventblindness.org/age-related-macular-degeneration-amd

What is Low Vision?
Low vision is defined as 20/60 or worse or a visual field less than 10 degrees.

What is Legal Blindness?
Legal blindness is 20/200 or worse or a visual field less than 20 degrees.

Why is Low Vision Awareness Important?
The most common causes of low vision in the USA are macular degeneration, followed by glaucoma and diabetic retinopathy. Identifying patients with low vision enables physicians to prescribe visual aids such as single vision reading glasses, high power magnifiers, and closed circuit TV monitors to assist with activities of daily living.

Where can I get help if I have Low Vision?
Talk to your eye physician.
Vision Aware - National Braille Literacy Month is January
Virginia Department for the Blind and Vision Impaired
Prevent Blindness America
American Foundation for the Blind
Foundation Fighting Blindness

Glaucoma: The 'silent thief' begins to tell its secrets

January 21, 2014

Glaucoma is sometimes called the "silent thief of sight" because it slowly damages the eyes and can cause irreparable harm before there is any vision loss. But this disease is stealthy in more ways than one. Glaucoma has been known at least since antiquity, and yet, researchers today still do not know what causes it in most cases. There are treatments to delay vision loss, but no cure, making it a leading cause of blindness all over the world.

Glaucoma is a group of diseases that damage the optic nerve, a cable at the back of each eye that connects it to the brain. It affects more than 2.7 million people in the United States and more than 60 million worldwide. There are many forms of the disease, but primary open-angle glaucoma is the most common form and the most mysterious.

Since January is Glaucoma Awareness Month, it's a good time to ask: Are researchers making progress in solving this mystery?

"Primary open-angle glaucoma remains a black box, but researchers are pursuing many avenues to investigate the underlying causes. As we develop a better understanding of the disease process, we hope this will lead to new, more effective treatments and possibly even preventive therapies for it," said Hemin Chin, Ph.D., director of the Glaucoma and Optic Neuropathies program at the National Eye Institute (NEI), part of the National Institutes of Health.

High-pressure research
If you've ever had an air-puff test, also known as tonometry, then you may have heard that glaucoma is linked to an increase in eye pressure, or intraocular pressure. The unique anatomy of the eye, when combined with other factors, can cause a rise in eye pressure that can in turn cause some types of glaucoma.

The eye is filled with fluid that drains through a gap between the cornea and iris. A build-up of fluid and eye pressure can damage the optic nerve.

 

The front of the eye, between the cornea (the eye's front window) and the iris (the colored part of the eye), is filled with a clear fluid. This fluid leaves the eye and enters the blood by passing through a gap at the angle where the cornea and iris meet. The gap is filled with a sponge-like tissue called the trabecular meshwork, which helps regulate fluid passage. Sometimes, eye infections, injuries, or certain medications can narrow the gap and compress this spongy tissue, producing a rapid buildup of fluid and eye pressure. This is called angle-closure glaucoma.

In the United States, open-angle glaucoma is more common than angle-closure glaucoma, affecting about three times as many people. It has a more gradual course and there are no clear signs of blockage within the eye's drainage system. Yet, researchers estimate that 50 to 80 percent of people with open-angle glaucoma have eye pressure that is higher than average. Others have normal pressure or even low pressure. On the flip side, many people have high eye pressure but never develop glaucoma.

Dr. Robert Weinreb. Credit: UCSD

 

"Elevated intraocular pressure is a leading risk factor for primary open-angle glaucoma," said Robert N. Weinreb, M.D., chair and distinguished professor of ophthalmology, and director of the Hamilton Glaucoma Center at the University of California, San Diego (UCSD). "The higher the intraocular pressure, the more likely the person is to develop glaucoma and the more likely it is to progress."
Because of these data, medications that lower eye pressure are a mainstay of glaucoma treatment. In some cases, a doctor may recommend surgery to increase fluid drainage from the eye. Drugs, surgery, or both approaches together are often successful at slowing the course of open-angle glaucoma. The NEI-funded Ocular Hypertension Treatment Study also found that pressure-lowering eye drops can delay the onset of glaucoma in people with high eye pressure. But even with medication or surgery, open-angle glaucoma usually continues to attack the optic nerve and cause gradual vision loss.

Other clues to glaucoma
There are other risk factors for open-angle glaucoma besides high eye pressure, and they may provide some clues about what causes it. For example, age is a clear risk factor. Open-angle glaucoma is rare among Americans under age 50, but affects nearly eight percent of Americans over 80.

Other risks come into play long before we grow old and even before we're born, including our ancestry. Open-angle glaucoma is about five times more common among African Americans and Mexican Americans compared to whites, and it has an earlier, more rapid course in African Americans. Family history also has a strong influence. A person's risk of developing open-angle glaucoma is about 10 times higher if a parent or sibling has it, and the risk is higher still if an identical twin has it.

These data from family and twin studies have prompted researchers to dig more deeply into the genetics of open-angle glaucoma. It turns out that sometimes open-angle glaucoma is passed from parent to child due to defects within a single gene. Eight such genes have been identified so far, and they tend to cause glaucoma with an early onset, before age 50. Thanks to these discoveries, there are now genetic tests that can help people with early-onset glaucoma determine the risk that their children will inherit the disease.

Unfortunately, it's rare that primary open-angle glaucoma can be traced to a single cause. In the vast majority of cases, experts theorize that the risk of the disease is influenced by many small genetic differences that vary from person to person. Alone, a single gene probably has a small impact on glaucoma risk.

Dr. Janey Wiggs.
Credit: Massachusetts Eye and Ear Infirmary.

 

"It's like tossing little pebbles into a pool," said Janey Wiggs, M.D., Ph.D., associate director of the Ocular Genomics Institute at the Massachusetts Eye and Ear Infirmary, part of Harvard Medical School in Boston. "They only have a big impact when a bunch of them are thrown in together."

The search for glaucoma genes
Dr. Wiggs and other researchers are conducting ambitious studies to compare the full genetic makeup—or genome—of people who have open-angle glaucoma to people who are free from the disease. They hope to sort out all of the suspected genetic differences that put people at risk.
This research began more than 20 years ago. Two of Dr. Wiggs' colleagues at Harvard—Susan Hankinson, Sc.D., and Louis Pasquale, M.D.—had begun monitoring for open-angle glaucoma cases and collecting genetic samples from participants in two large public health studies. Dr. Wiggs began another genetic study of open-angle glaucoma in 1996, based on patients seen through the glaucoma service at Massachusetts Eye and Ear. But progress in these studies was painstakingly slow.

The pace accelerated dramatically with the completion of the NIH-led Human Genome Project in 2003, and the advent of technology to rapidly and cheaply decode each person's unique genome. Soon, Dr. Wiggs and her Harvard colleagues merged their efforts, and began working with researchers at other sites. In 2012, with funding and additional guidance from NEI, Dr. Wiggs began leading the NEI Glaucoma Human Genetics Collaboration (NEIGHBOR). This consortium includes 12 institutions across the U.S., and has collected genetic samples from about 4,500 patients and about 20,000 (control) individuals without the disease. Recently, it has been expanded to include a number of other ongoing studies, and to build a database of genetic and clinical information on glaucoma cases and controls, called the NEIGHBOR Heritable Overall Operational Database (NEIGHBORHOOD). There are also major genetic studies of glaucoma based in the United Kingdom, Australia, Singapore, and Iceland.

So far, these efforts have uncovered five regions of the genome that are strongly associated with primary open-angle glaucoma, Dr. Wiggs said. Within each region, investigators have found specific genes that, together, form a line-up of suspects believed to contribute to the disease. "Every gene has its own story, but most of them divide neatly into two groups," she said. "There are some that impact eye pressure and others that impact the optic nerve."

Remember the trabecular meshwork, the spongy tissue that regulates fluid flow out of the eye? At least two of the genes linked to higher eye pressure and higher glaucoma risk appear to affect the function of this tissue, Dr. Wiggs said.

Genes affecting the cornea may also have an effect on glaucoma risk, she said. Many past studies have found that people with thin corneas are more likely to develop open-angle glaucoma. The NEIGHBOR consortium has found genetic factors that are associated with both a decrease in corneal thickness and an increase in the risk of open-angle glaucoma.

Linking genes with other risk factors
Another effort that is yielding data on glaucoma risk is the African Descent and Glaucoma Evaluation Study (ADAGES). This NEI-funded study was launched in 2002, in order to seek explanations for the high prevalence and rapid course of primary open-angle glaucoma in African Americans. Dr. Weinreb is leading it in collaboration with his UCSD colleague Linda Zangwill, Ph.D., and with Jeffrey Liebmann, M.D., at New York University Langone Medical Center, and Christopher Girkin, M.D., at the University of Alabama at Birmingham.

Soon after the study began, the researchers found that, compared to whites, African Americans have thinner corneas and subtle abnormalities in the visual field that aren't detected with standard diagnostic tests. (The visual field is the area of space a person can see at a given instant without moving the eyes.) These abnormalities may be an early sign of disease. Recently, the study has expanded to include a search for genetic factors that put African Americans at risk for open-angle glaucoma.

"By identifying genetic and non-genetic factors associated with glaucoma in this high-risk population, we hope to develop better means to diagnose it and detect progression, and improved drug targets that could benefit all patients," Dr. Weinreb said.

There is likely much more to glaucoma risk than a person's genes. Lifestyle, environment, and other factors are also believed to play a role, experts say. Various studies have examined the potential role of smoking, alcohol, caffeine, fat intake, and exercise in open-angle glaucoma, but so far, none of these has shown a strong relationship with the disease. In women, earlier age at menopause has been linked to a higher risk of the disease. In collaboration with Dr. Pasquale at Harvard, Dr. Wiggs has found that in women, but not men, open-angle glaucoma is associated with small variations in genes that regulate the reproductive hormone estrogen. These findings have led to speculation that estrogen replacement therapy may help protect older women from glaucoma, but research on this topic is inconclusive.

"As a community, there's still a lot we don't know about glaucoma," Dr. Wiggs said. "However, we've been able to achieve some success by pooling resources and ideas. I think we will see more rapid progress in the next few years."

Protecting yourself against glaucoma
Even though the risks of glaucoma aren't fully understood, remembering these tips can help you protect yourself and your family against it:

• People at higher risk include African Americans age 40 and older, everyone over age 60, especially Mexican Americans, and those with a family history of the disease.
• Because glaucoma often has no symptoms in its early stages, people at higher risk should have a comprehensive dilated eye exam every one to two years.
• With early detection and treatment, it is possible to slow progression of the disease and preserve vision.

NEI has more information about how to reduce your risk of vision loss from glaucoma, including this fact sheet and video. The NEIGHBORHOOD study is funded by NEI grant EY022305 and ADAGES is funded by NEI grant EY023704.

January is Glaucoma Awareness Month

Glaucoma, the “Sneak Thief of Sight,” May Strike Without Pain or Other Symptoms

The Oregon Optometric Physicians Association Offers Advice to Help Protect Against Vision Loss - Washington, DC (12/31/13)

January is National Glaucoma Awareness Month and the American Optometric Association (AOA) is urging people of all ages to take control of their eye health through early detection to help minimize the risk of developing glaucoma. Glaucoma leads to progressive damage to the optic nerve and a loss of nerve tissue resulting in loss of vision.

Currently, 2.7 million people in the United States over age 40 have glaucoma, one of the leading causes of blindness in the U.S., yet understanding and awareness of the disease is still relatively low. According to data from the AOA’s 2013 American EyeQ® consumer survey, Americans do not fully understand glaucoma:

● 72 percent think glaucoma has early warning signs—it does not –only a comprehensive eye exam administered by an eye doctor can detect the disease

● 86 percent don’t know what part of vision glaucoma affects— progressive deterioration to peripheral vision making it hard to see

● 47 percent think glaucoma is preventable—it is not preventable but it may be treated and progression can be slowed if it is detected and treated early

“Yearly, comprehensive eye exams play a critical role in detection and treatment of glaucoma,” said Robert Bittel, O.D., Chair of the AOA’s Health Promotion Committee. “Dilated eye exams allow eye doctors to thoroughly examine the pressure and nerves inside the eyes for potential signs of the disease. Early detection, prompt treatment and regular monitoring can help control glaucoma, and therefore, reduce the chances of progressive vision loss.”

Americans are also unaware if they are at risk for developing glaucoma: only 13 percent of Americans know that a person’s race could place them at a higher risk of developing glaucoma. According to the Glaucoma Research Foundation, glaucoma is six to eight times more common in African Americans than Caucasians. Additional factors that can increase the risk of developing glaucoma include those who have a family history of glaucoma, hypothyroidism, are over age 60 or individuals who have had severe eye trauma.

Treatment for glaucoma includes prescription eye drops and medicines to lower pressure in the eyes. In some cases, laser treatment or surgery may be effective in reducing pressure.

In addition to regular, comprehensive eye exams, the AOA recommends incorporating a few tips to help maintain overall eye health and clear, comfortable vision:

● Eat green, leafy vegetables and foods rich in nutrients like beta carotene, vitamin C and zinc to protect eyes from disease.

● Stop smoking and cut down on alcohol and caffeine when possible. .

● If you work in front of a computer, practice the 20/20 rule: every 20 minutes, take a 20 second break to help avoid eye strain and computer vision syndrome.

● Wear sunglasses with UVA and UVB protection year round.

● See your optometrist if you are experiencing stinging, itchy, or scratchy eyes, excessive tearing, or any eye discomfort or reduced vision; he or she may recommend artificial tears or tear substitutes, or prescribe medication.