Visual Impairment and Blindness in the Senior Population
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Vision Rehabi I Itation for Patients with Age Related Macular Degeneration
Vision rehabi I itation for GARY S. RUBIN patients with age related macular degeneration Epidemiology of low vision The over-representation of macular degeneration patients in the low-vision clinic is The epidemiology of vision impairment is dealt reflected in the chief complaints of those with in detail elsewhere.1 However, there is one referred for rehabilitation. A study of 1000 particularly salient factor that bears emphasis. consecutive patients seen at the Wilmer Low The prevalence of vision impairment increases Vision clinic indicated that 64% listed 'reading' dramatically with advancing age. Statistics as their chief complaint, while other activities compiled in the UK by the Royal National were identified by fewer than 8% of patients. Institute for the Blind2 indicate that there were Undoubtedly the bias towards reading approximately 1.1 million blind or partially problems results partly from the nature of the sighted persons in 1996, of whom 82% were 65 low-vision services offered. Those served by a years of age or older. Thus it is not surprising to community-based programme that includes learn that the major causes of vision impairment home visits might be more likely to report are age-related eye diseases. Fig. 1 illustrates the problems with activities of daily living, while a distribution of causes of vision impairment blind rehabilitation centre would be more likely 5 from three recent studies?- Approximately to address mobility issues. Nevertheless, most equal percentages are attributed to macular macular degeneration patients are referred to degeneration and cataract, with smaller hospital or optometry clinic services, and as percentages for glaucoma, diabetic retinopathy their overwhelming concern is with reading, and optic neuropathies. -
ICO Guidelines for Glaucoma Eye Care
ICO Guidelines for Glaucoma Eye Care International Council of Ophthalmology Guidelines for Glaucoma Eye Care The International Council of Ophthalmology (ICO) Guidelines for Glaucoma Eye Care have been developed as a supportive and educational resource for ophthalmologists and eye care providers worldwide. The goal is to improve the quality of eye care for patients and to reduce the risk of vision loss from the most common forms of open and closed angle glaucoma around the world. Core requirements for the appropriate care of open and closed angle glaucoma have been summarized, and consider low and intermediate to high resource settings. This is the first edition of the ICO Guidelines for Glaucoma Eye Care (February 2016). They are designed to be a working document to be adapted for local use, and we hope that the Guidelines are easy to read and translate. 2015 Task Force for Glaucoma Eye Care Neeru Gupta, MD, PhD, MBA, Chairman Tin Aung, MBBS, PhD Nathan Congdon, MD Tanuj Dada, MD Fabian Lerner, MD Sola Olawoye, MD Serge Resnikoff, MD, PhD Ningli Wang, MD, PhD Richard Wormald, MD Acknowledgements We gratefully acknowledge Dr. Ivo Kocur, Medical Officer, Prevention of Blindness, World Health Organization (WHO), Geneva, Switzerland, for his invaluable input and participation in the discussions of the Task Force. We sincerely thank Professor Hugh Taylor, ICO President, Melbourne, Australia, for many helpful insights during the development of these Guidelines. International Council of Ophthalmology | Guidelines for Glaucoma Eye Care International -
Symptoms of Age Related Macular Degeneration
WHAT IS MACULAR DEGENERATION? wavy or crooked, visual distortions, doorway and the choroid are interrupted causing waste or street signs seem bowed, or objects may deposits to form. Lacking proper nutrients, the light- Age related macular degeneration (AMD) is appear smaller or farther away than they sensitive cells of the macula become damaged. a disease that may either suddenly or gradually should, decrease in or loss of central vision, and The damaged cells can no longer send normal destroy the macula’s ability to maintain sharp, a central blurry spot. signals from the macula through the optic nerve to central vision. Interestingly, one’s peripheral or DRY: Progression with dry AMD is typically slower your brain, and consequently your vision becomes side vision remains unaffected. AMD is the leading de-gradation of central vision: need for increasingly blurred cause of “legal blindness” in the United States for bright illumination for reading or near work, diffi culty In either form of AMD, your vision may remain fi ne persons over 65 years of age. AMD is present in adapting to low levels of illumination, worsening blur in one eye up to several years even while the other approximately 10 percent of the population over of printed words, decreased intensity or brightness of eye’s vision has degraded. Most patients don’t the age of 52 and in up to 33 percent of individuals colors, diffi culty recognizing faces, gradual increase realize that one eye’s vision has been severely older than 75. The macula allows alone gives us the in the haziness of overall vision, and a profound drop reduced because your brain compensates the bad ability to have: sharp vision, clear vision, color vision, in your central vision acuity. -
Macular Degeneration
DRIVEWELL Driving When You Have Macular Degeneration You have been a safe driver for years. For you, driving means freedom and control. As you get older, changes in your physical and mental health can affect how safely you drive. Macular degeneration (also known as age-related macular degeneration) damages the macula, a spot near the center of the retina (light-sensitive inner lining of the eyeball). It is a common eye problem among older drivers that makes it hard to drive safely. Age-related macular degeneration is the leading cause of new cases of blindness in people 65 and older. If you have macular degeneration, you may not notice any signs in the early stages. You may not know you have this condition until you lose your peripheral vision (what you see out of the corner of your eyes). In time it will affect your central vision, causing a dark or empty area in the center of your vision. How Can Macular Degeneration Affect the Way I Drive? • Your central vision may be dull and blurry. This can lead to loss of sharp vision. • You may not see the road, street signs, lane markers, and even people and bicyclists in the road. • You may need more bright light to see up close. • Colors may look less vivid or bright. • You may have trouble when you go from bright light to low light. • You may not be able to recognize people’s faces. What Should I Do if I Have Any of These Signs? As soon as you notice any of these warning signs: • Tell your family or someone close to you, especially if you have a family history of macular degeneration or have changes in your central vision. -
Detached and Torn Retina Retinal Detachments Occur in 1 out of 10,000 Americans Each Year
Detached and Torn Retina Retinal Detachments Occur in 1 Out of 10,000 Americans Each Year A retinal detachment is not as common as other eye conditions such as glaucoma or macular degeneration, however… it is just as serious and it is a vision threatening condition which should be treated as an emergency. Dr. Randy Katz, Florida Eye’s Diabetic Retinopathy, Retinal Detachment & Macular Degeneration Specialist says that the sooner a retinal tear or detachment is treated the better the chances of saving the vision in the eye. What Is a Retinal Detachment? The retina is the light-sensitive layer of tissue that lines the inside of the eye and sends visual messages through the optic nerve to the brain. When the retina detaches, it is lifted or pulled from its normal position. When this occurs, if not promptly treated, retinal detachment can cause permanent vision loss. In some cases there may be small areas of the retina that are torn. These areas, called retinal tears or retinal breaks, can lead to a retinal detachment. Vitreous gel, the clear material that fills the eyeball, is attached to the retina in the back of the eye. As we get older, the vitreous may change shape, pulling away from the retina. If the vitreous pulls a piece of the retina with it, it causes a retinal tear. Once a retinal tear occurs, vitreous fluid may seep through and lift the retina off the back wall of the eye, causing the retina to detach or pull away. 2 Are You At Risk for a Torn or Detached Retina? A retinal detachment can occur at any age, but it is more common in people over age 40. -
Presbyopia and Glaucoma: Two Diseases, One Pathophysiology? the 2017 Friedenwald Lecture
Lecture Presbyopia and Glaucoma: Two Diseases, One Pathophysiology? The 2017 Friedenwald Lecture Paul L. Kaufman,1 Elke Lutjen¨ Drecoll,2 and Mary Ann Croft1 1Department of Ophthalmology and Visual Sciences, Wisconsin National Primate Research Center, McPherson Eye Research Institute, University of Wisconsin-Madison, Madison, Wisconsin, United States 2Institute of Anatomy II, Erlangen, Germany Correspondence: Paul L. Kaufman, Department of Ophthalmology and Visual Sciences, University of Wisconsin Clinical Sciences Center, 600 Highland Avenue, Madison, WI 53792-3220, USA; [email protected]. Citation: Kaufman PL, Lutjen¨ Drecoll E, Croft MA. Presbyopia and glaucoma: two diseases, one pathophysiology? The 2017 Friedenwald Lecture. Invest Ophthalmol Vis Sci. 2019;60:1801–1812. https://doi.org/10.1167/iovs.19-26899 resbyopia, the progressive loss of near focus as we age, is choroid and the retina stretch in parallel with each other during P the world’s most prevalent ocular affliction. Accommoda- the accommodative response. The question remains how far tive amplitude is at its maximum (~15 diopters) in the teen back the accommodative choroid/retina movement goes. years and declines fairly linearly thereafter (Fig. 1).1 By age 25 By ‘‘marking’’ points on retinal photographs (e.g., vascular about half the maximum accommodative amplitude has been bifurcations) in aphakic (to avoid lens magnification artifacts lost, by age 35 two-thirds are gone, and by the mid-40s all is during accommodation) monkey eyes, movement of the retina gone. Clinical symptoms usually begin at age ~40. The during accommodation can be quantified in terms of both accommodative apparatus of the rhesus monkey is very similar direction and magnitude (Fig. -
Cataract Surgery & Glaucoma
worldclasslasik.com http://www.worldclasslasik.com/cataract-surgery-new-jersey/cataract-surgery-glaucoma/ Cataract Surgery & Glaucoma The lens of your eye is responsible for focusing light on the objects you see. If the lens is clouded, then you can’t see things clearly, and this is known as a cataract. It can form gradually over many years or you can be born with a cataract. For some people, cataracts are not even noticeable. They just find themselves turning on more lights to read or having trouble with glares while driving at night. Most cataracts are problematic later in life. It is estimated that more than half of all Americans over the age of 80 will have cataracts or have had them corrected with surgery. Another common eye problem for seniors is glaucoma. Glaucoma is actually a group of eye diseases that affect the optic nerve by causing various types of damage due to high pressure. The optic nerve carries images from the retina to the brain, so advanced glaucoma can actually impair vision to the point of blindness. It is actually the leading cause of blindness in the world. However, glaucoma can be remedied in a number of ways. Early detection and treatment by your eye surgeon are critical in achieving optimal results. Resolve Cataracts and Glaucoma with Surgery While many adults over the age of 65 suffer from both cataracts and glaucoma, it is important to note that the two are not related. Glaucoma does not cause cataracts and cataracts do not cause glaucoma. That being said, cataract surgery involves creating a small incision in the lens of the eye to remove the affected, or “cloudy” area of the lens. -
Miotics in Closed-Angle Glaucoma
Brit. J. Ophthal. (I975) 59, 205 Br J Ophthalmol: first published as 10.1136/bjo.59.4.205 on 1 April 1975. Downloaded from Miotics in closed-angle glaucoma F. GANIAS AND R. MAPSTONE St. Paul's Eye Hospital, Liverpool The initial treatment of acute primary closed-angle Table i Dosage in Groups I, 2, and 3 glaucoma (CAG) is directed towards lowering intraocular pressure (IOP) to normal levels as Group Case no. Duration IOP Time rapidly as possible. To this end, aqueous inflow is (days) (mm. Hg) (hrs) reduced by a drug such as acetazolamide (Diamox), and aqueous outflow is increased via the trabecular I I 2 8 5 meshwork by opening the closed angle with miotics. 3 7 21 3 The use of miotics is of respectable lineage and hal- 5 '4 48 7 lowed by usage, but regimes vary from "intensive" 7 8 I4 5 9 I0 I8 6 (i.e. frequent) to "occasional" (i.e. infrequent) instilla- I I 2 12 6 tions. Finally, osmotic agents are used after a variable '3 5 20 6 interval of time if the IOP remains raised. Tlle pur- I5 '4 I8 6 pose of this paper is to investigate the value of '7 '4 i6 6 miotics in the initial treatment of CAG. I9 6 02 2 2 2 8 2I 5 Material and methods 4 20t 20 6 Twenty patients with acute primary closed-angle glau- 6 I i8 5 http://bjo.bmj.com/ coma were treated, alternately, in one of two ways 8 4 i8 5 detailed below: I0 6 I8 6 I2 I0 20 6 (I) Intravenous Diamox 500 mg. -
Drug Class Review Ophthalmic Cholinergic Agonists
Drug Class Review Ophthalmic Cholinergic Agonists 52:40.20 Miotics Acetylcholine (Miochol-E) Carbachol (Isopto Carbachol; Miostat) Pilocarpine (Isopto Carpine; Pilopine HS) Final Report November 2015 Review prepared by: Melissa Archer, PharmD, Clinical Pharmacist Carin Steinvoort, PharmD, Clinical Pharmacist Gary Oderda, PharmD, MPH, Professor University of Utah College of Pharmacy Copyright © 2015 by University of Utah College of Pharmacy Salt Lake City, Utah. All rights reserved. Table of Contents Executive Summary ......................................................................................................................... 3 Introduction .................................................................................................................................... 4 Table 1. Glaucoma Therapies ................................................................................................. 5 Table 2. Summary of Agents .................................................................................................. 6 Disease Overview ........................................................................................................................ 8 Table 3. Summary of Current Glaucoma Clinical Practice Guidelines ................................... 9 Pharmacology ............................................................................................................................... 10 Methods ....................................................................................................................................... -
Association Between Visual Field Damage and Corneal Structural
www.nature.com/scientificreports OPEN Association between visual feld damage and corneal structural parameters Alexandru Lavric1*, Valentin Popa1, Hidenori Takahashi2, Rossen M. Hazarbassanov3 & Siamak Yousef4,5 The main goal of this study is to identify the association between corneal shape, elevation, and thickness parameters and visual feld damage using machine learning. A total of 676 eyes from 568 patients from the Jichi Medical University in Japan were included in this study. Corneal topography, pachymetry, and elevation images were obtained using anterior segment optical coherence tomography (OCT) and visual feld tests were collected using standard automated perimetry with 24-2 Swedish Interactive Threshold Algorithm. The association between corneal structural parameters and visual feld damage was investigated using machine learning and evaluated through tenfold cross-validation of the area under the receiver operating characteristic curves (AUC). The average mean deviation was − 8.0 dB and the average central corneal thickness (CCT) was 513.1 µm. Using ensemble machine learning bagged trees classifers, we detected visual feld abnormality from corneal parameters with an AUC of 0.83. Using a tree-based machine learning classifer, we detected four visual feld severity levels from corneal parameters with an AUC of 0.74. Although CCT and corneal hysteresis have long been accepted as predictors of glaucoma development and future visual feld loss, corneal shape and elevation parameters may also predict glaucoma-induced visual functional loss. While intraocular pressure (IOP), age, disc hemorrhage, and optic cup characteristics have been long identifed as classic risk factors for development of primary open-angle glaucoma (POAG)1,2, the Ocular Hypertension Treatment Study (OHTS) suggested central corneal thickness (CCT) as a new risk factor for development of POAG3. -
Flammer Syndrome, a Potential Risk Factor for Central Serous Chorioretinopathy?
Review Article ISSN: 2574 -1241 DOI: 10.26717/BJSTR.2020.24.004026 Flammer Syndrome, A Potential Risk Factor for Central Serous Chorioretinopathy? Tatjana Josifova 1*, Franz Fankhauser1 and Katarzyna Konieczka1,2 1Augenzentrum Prof Fankhauser, Bern, Switzerland 2Universitätspital Basel, Augenklinik, Basel, Switzerland *Corresponding author: Tatjana Josifova, Augenzentrum Prof Fankhauser, Bern, Switzerland ARTICLE INFO Abstract Received: December 16, 2019 Central serous chorioretinopathy (CSCR) is forth most common retinal disease, Published: January 06, 2020 mostly affecting men in their third and fourth life decade. Changes most often involve the macula and are associated with pigment epithelial and neurosensory retinal detachment. The literature highlights an involvement of the choroidal veins and pigment Citation: Tatjana Josifova, Franz Fankhaus- epithelium in the pathogenesis of CSCR. Nevertheless, both the risk factors and the molecular mechanisms of CSCR remain uncertain. The Flammer syndrome refers to a er, Katarzyna Konieczka. Flammer Syn- phenotype characterized by the combination of primary vascular dysregulation with drome, A Potential Risk Factor for Central a cluster of additional symptoms and signs. Subjects affected by the syndrome have Serous Chorioretinopathy?. Biomed J Sci & a predisposition to react differently to a number of stimuli, such as cold, physical or Tech Res 24(2)-2020. BJSTR. MS.ID.004026. emotional stress, or high altitude. We postulate that Flammer syndrome might be one of the risk factors for CSCR. This -
Prevalence and Quantification of Geographic Atrophy Associated With
Downloaded from http://bjo.bmj.com/ on August 18, 2017 - Published by group.bmj.com Clinical science Prevalence and quantification of geographic atrophy associated with newly diagnosed and treatment- naïve exudative age-related macular degeneration Anne Sikorav,1 Oudy Semoun,1 Sandrine Zweifel,2 Camille Jung,3 Mayer Srour,1 Giuseppe Querques,1,4 Eric H Souied1 10–14 ► Additional material is ABSTRACT develop, causing further vision loss. Most published online only. To view Objective To identify and quantify geographic atrophy studies focus on either wet or dry form separately please visit the journal online (GA) associated with neovascular age-related macular and there is a paucity of reports on both forms of (http:// dx. doi. org/ 10. 1136/ bjophthalmol- 2015- 308065). degeneration (AMD) at initial presentation using a AMD concomitantly in the same eye. There are fundus autofluorescence (FAF) semi-automated software recent published data regarding the prevalence of – 1Department of Ophthalmology, and to correlate the results with demographic and GA complicating exudative AMD at diagnosis,14 16 University Paris Est, Centre clinical data. with diverse results. Hospitalier Intercommunal de Creteil, Creteil, France Design Retrospective, observational study. In both atrophic and exudative AMDs, RPE 2Department of Ophthalmology, Methods The study population consisted of treatment- damage may be an important factor for visual loss. University Hospital Zurich, naïve patients with newly diagnosed neovascular AMD. The status of RPE can be studied by blue light Zurich, Switzerland Best-corrected visual acuity, fundus photographs, infrared fundus autofluorescence (FAF) imaging, which is a 3 Clinical Research Center, reflectance, FAF and spectral-domain optical coherence non-invasive imaging method that allows for topo- University Paris Est fl Creteil, Centre Hospitalier tomography were performed, associated with uorescein graphic mapping of lipofuscin distribution in the 17 18 intercommunal de Creteil, and indocyanine green angiographies.