2/27/2020 Eliesa Ing, MD Assistant Professor Casey Eye Institute, division of glaucoma sclera ciliary choroid body cornea retina lens anterior chamber optic nerve iris Medbullets.com Californiaretina.com 1 2/27/2020 . AREDS . Vitamin C – 500 mg . Vitamin E – 400 IU . Zinc – 80 mg . Copper – 2 mg . Beta-carotene* - 15 mg . AREDS 2 . Lutein . Zeaxanthin . NO beta-carotene When do you screen According to UK vision strategy report in 2014: for depression? . 1/3 of patients with vision loss suffer from depression . Adults with vision loss are 90% more likely to have A) At every visit depression B) At select visits . Difficulty with driving increased the rate of C) Only if the patient has a depression by 25% complaint/ROS regarding psychiatric disease/symptoms . Second leading cause of world blindness . Over 3 million people in the USA . 50% are undiagnosed . Over 120,000 patients are blind from glaucoma in the U.S. https://nei.nih.gov/sites/default/files/nei- images/1_2010_Prevalence_Rates_Age_Race_Glaucoma_v4.jpg 2 2/27/2020 .Group of eye diseases .Loss of optic nerve axons .In a characteristic pattern .Often associated with elevated eye pressure 3 2/27/2020 4 2/27/2020 . Macular edema (ME) . Retinal infarcts = cotton wool spots (CWS) . Retinal hemorrhages = dot blot hemes (DBH) . Blood vessels where they don’t belong = Proliferative Diabetic Retinopathy (PDR) . Comes and goes . Worse with decreased blinking . Worse with reduced humidity . Instability in any layer . Oil layer most common . Water layer . LASIK, sjogren’s, age . Eye drops can dry cornea 5 2/27/2020 . ARMD is significantly worsened by tobacco use . Glaucoma is the “hypertension” of the eye world . Cataract surgery will never restore you vision completely to your youth . A diabetic eye exam means they had dilation or “DFE” . Dry eyes is only fixed with active patient participation . Low vision places people at high risk for depression 6.