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Archive for the ‘Eye Disease’ Category

What to do when your eye doctor asks more than just "which is better, 1 or 2?"

If your optometrist asks you if you have recently had your cholesterol and lipid levels checked, they may not be just making conversation. Did you know that during an eye exam the eye doctor is looking for cholesterol?

(They might even be able to spot it in the waiting room. Yellowish, fatty deposits of cholesterol can appear on the skin of and around the eyelids. These deposits are called Xanthelasma and can be seen with the naked eye. If your eye doctor spots and identifies these plaques on the skin as Xanthelasma, it will be necessary to get your cholesterol checked. Now, let’s go into the exam room…)

With the biomicroscope, your doctor searches for cholesterol in your eyes in two more places, one of which is the cornea where cholesterol can deposit in an arc-like formation, circling the outer cornea resembling a white, gray or yellowish ring around the normally clear corneal tissue.  This ring is called Arcus Senilis in those over 60 years of age and is often considered a normal finding as the cornea is one of the places in the body where cholesterol can naturally accumulate over the course of one’s lifetime. Have you ever seen this in your grandparents’ eyes? It almost looks like a halo in front of their iris and I have had some patients with it tell me that their eye color ‘has gotten lighter’ which of course isn’t the case, it just may appear that way through the white veil of cholesterol.

If you are under 60 or even more strikingly under 40, and corneal arcus is noted by your doctor then they may ask about your lipid levels, the last time you had blood work done and also may note any family history of high cholesterol or other cardiovascular conditions.

Cholesterol is an essential component in cell structures and as you have probably heard sometimes cholesterol isn’t such a bad guy. If your optometrist sees cholesterol deposited on your cornea, further testing is needed to determine whether or not the cholesterol there is a sign of something you should be worried about. To learn more about lighter side of cholesterol and why we absolutely need it in our lives (and our cells), check out this awesomely cute article by Jeanne Garbarino and video by Perrin Ireland!

The second place cholesterol can show up is inside the eye in the arteries of the retina. A piece of cholesterol may even be seen stuck in one of the retinal arteries usually at a bifurcation or branching point of an artery. When this happens that once free-floating piece of cholesterol now momentarily lodged  in the retinal artery is referred to as a hollenhorst plaque. If your eye doctor sees this, they will quickly refer you to your general physician for additional evaluation and testing to determine from where this embolus originated. In other words, if there are small plaques of cholesterol lodged in small arteries of the body there may be larger plaques in larger arteries of the body. These larger plaques put you at risk for heart attacks and strokes. Since the presence of hollenhorst plaques is a sign of severe atherosclerosis,  if cholesterol is seen in the retinal arteries inside the eye, your doctor will take it very seriously. And so should you.

The eyes can tell you a lot about your health so the next time your eye doctor asks you about your medical history or your family medical history, be honest, be open and tell them all about it. It may turn into one of the most important conversations of your life, one that can save it.

Keep the Conversation with your Eye Doctor going. There is a reason why they are asking each question.

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Myopic Macular Degeneration can disrupt the central vision of young people making it difficult for them to focus on reading and other activities but there are new treatment options and research which are giving them new hope!

I received this topic by request from a lovely, young woman who has this condition. Although I never examined her myself I feel the need to help others understand the conditions they themselves face and also feel the responsibility to educate others out there on this very important subject. Myopic Macular Degeneration is not to be confused with its similar sounding eye illness, Age-related Macular Degeneration. By contrast, Myopic Macular Degeneration usually happens to young people who have a high amount of nearsight and face complications from elongation of the eye and the stretching of its structures within.

As I was writing this article, I found it to be a tougher topic to present than I thought it would be. There is still much to be learned about the exact reasons and ways this condition progresses. Various treatment options and preventative measures have been tried in an effort to halt this condition but there has not been a true, definitive answer on how to stop it. The good news is, it is starting to draw more and more attention especially with the most recent discoveries of the anti-VEGF drugs being more effective than older treatments such as photodynamic therapy or PDT. (source 4) The exciting thing about anti-VEGF drugs is that they target and block ‘vascular endothelial growth factor’ which they believe is a signal that triggers the growth of new blood vessels. New blood vessel growth below the retina (choroidal neovascularization) is one of the potential dangers in Myopic Macular Degeneration. These anti-VEGF drugs are administered by intravitreal injections at intervals determined by a patient’s doctor in hopes to prevent a recurrence of choroidal neovascularization in the direct center of the retina, the macula. They are giving new hope to patients and doctors alike.

In order to really understand myopic macular degeneration, let’s first talk about just plain myopia or nearsightedness. We’ll then move on to Degenerative Myopia and then to Myopic Macular Degeneration.

Physiological (common) Myopia:

In the simplest of terms, Myopia or Nearsightedness can occur in the eye either because ‘the eye is too long or too strong.’ This means that the eye has an axial length greater than average or the combined ocular power of the cornea and lens is higher than what it should be or both. If the eye is too long or too strong, the image of what you are seeing will focus ‘too soon,’ in front of the retina. These leads to a fuzzy image being captured by the retina and thus results in blurry vision. Usually this disparity of optics can be easily corrected for with contact lenses or glasses which focuses the eye’s image right back to where it should be collected in order to yield good, crisp clear vision. Myopia is usually considered to be just a variation of normal eyes if the prescription is around -6.00 or less and it is said to be “the most common eye disorder worldwide.” (source 1)

Degenerative Myopia:

If your prescription for glasses is much higher than a -6.00, and has gotten progressively worse as you grew older and into your middle age years, there may be a genetic component to your myopia causing the eye to become very long (in its axial length). Degenerative Myopia can be very dangerous to the health of the eye because it can lead to vision loss by either myopic macular degeneration or by a retinal detachment. Also, “more severe myopia and longer axial lengths have been linked to specific pathologies such as cataract, glaucoma, or lattice degeneration.” (source 2) Patient education and proper understanding of these complications are important steps in trying to help patients who suffer from Degenerative Myopia to avoid potential vision loss.

The elongation of the eye is what happens first in Degenerative Myopia. When the eye is much longer than it is wide, there is stretching of the tissues inside the eye and stretching of the retina. Sometimes stretching the retina is like stretching a t-shirt. If it is stretched too far and for too long, it can start to thin and little tiny holes and tears can develop in the retina. When this happens, your doctor will see signs in your eye such as posterior staphyloma, breaks in Bruch’s membrane and lacquer cracks which are complications of scleral thinning and eye elongation. These set the stage for choroidal neovascularization to occur which is new blood vessel growth just beneath the retina. (source 1) When new blood vessels grow, their walls are immature and they leak blood. This is what causes the damage in Myopic Macular Degeneration. Similar to the mechanism behind the damage in Age-Related Macular Degeneration, Myopic Macular Degeneration occurs when this leaked blood causes tissue damage to the overlying retina. Even if the blood is stopped from leaking further, if it was there long enough, it could have changed the architecture of the retina in such a way that disrupts its proper functioning in that area and can result in central vision loss.

Progression and severity of myopic macular degeneration varies widely among individuals. Some have choroidal neovascularization (CNV) and other complications, others never do. In those who have CNV, recurence is another thing that is not uniform, neither is the frequency of recurrence. Therefore, follow-up and treatments are very different among patients and are determined by the doctor.

So is there anything that can be done to prevent Myopic Macular Degeneration? Well, there are certainly precautions that can be taken in order to take a proactive, preventative approach if you have nearsightedness, high nearsightedness, or degenerative myopia.

Preventative Measures:

  • Yearly eye exams with dilation of the pupils to check the integrity of the retina
  • Adhere to follow-up schedules recommended by your doctor and take all of their recommendations and advice seriously.
  • Some experts say to avoid highly physical activities or sports which could result in a sharp blow or shaking of the head.
  • Proper Nutrition, make sure you are giving the cells of the macula and retina the building blocks they need to be as healthy and strong as possible.
  • At home monitoring of your central vision with an Amsler Grid as directed by your doctor
  • Protecting your eyes (cells of the macula and retina) from the UVA/UVB oxidative damage that can occur in repeated exposure to the sun. Wear proper sun protection/sunglasses.
  • Know your warning signs of a retinal detachment, if you see FLASHES of light in your vision or FLOATERS that look like curtains, cobwebs, spots that do not go away and increase in number, go to the eye doctor or ER immediately.

Remember, myopic macular degeneration can happen to young people, it is not an illness that occurs with age. To ensure you have good vision your whole life through, take a proactive approach, find an ophthalmologist or retinal specialist you trust and follow their recommendations to a T. Since much of the treatment is customized to the individual, it is essential you adhere to your recommended  follow-up appointments and to their treatment recommendations. It’s ok to ask them questions to understand how your eyes are doing and also to stay current with the latest treatment options available. Degenerative Myopia is re-surging as a hot topic in research and in regards to preventative care for Myopic Macular Degeneration, the future looks bright!

Dear Ms. G;

Thank you for requesting this topic, I hope I have helped you understand it a little bit better. It is a hard topic to cover since so much still remains unknown but I think it is important to review what we know now about it and educate others who may be searching for similar answers or information. If you have any questions at all, I would be more than happy to answer them. You can contact me directly or comment. You are not alone.

Sincerest Thanks

Cheryl G. Murphy, OD

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Happily Researching and Writing on Topics requested by You!

I am so very thankful that I received requests from readers and friends on what topics I should present next on my eye blog. I really enjoy delving into subjects that I may not encounter everyday. It stimulates my curiosity and refreshes my knowledge.  I also love the idea that I am helping someone out there who has questions whether they are my patient or not. Everyone deserves the chance to understand, to truly understand, conditions that they or their loved ones encounter. I do my best to present things in a manner that is clear and concise, although at times, in science, that is a bit dicey. But even if you gain one small piece of information from reading this that you did not have before, to me, it is all worth it and I am happy to help. Also, if you have any more specific questions on this topic after reading this, Contact Me and I will do my best to answer them. Still accepting topic requests so don’t be afraid to propose new topics either. And with that said, onward and upwards we soar toward our next topic, acute macular neuroretinopathy which I will abbreviate from here on out as AMNR.

AMNR is a rare condition disrupting the structures in the outer retina of one or both eyes. It occurs mainly in young women in their ‘reproductive’ years ages 20-50. No treatment is given, the condition is self-limited and usually resolves on its own though it may take months. Recurrence in one or both eyes is possible though not common. Also, in two reported cases, doctors found AMNR was followed by MEWDS (Multiple Evanescent White Dot Syndrome).

What the Doctor looks for: Upon examination of the retina they will find the sudden presence of red, wedge-shaped lesions in the center of the retina pointing toward the macula, sometimes described as ‘petaloid’ in their shape. These lesions can be flat or depressed and are best seen in red-free light. (source 1). They may be accompanied by one or two flame-shaped hemorrhages.

What the Patient experiences: The patient’s vision is reduced since the retina, the sight-seeing tissue of the eye, is affected and they will complain of blurry vision. They will also experience the loss of ‘puzzle pieces’ surrounding their central vision, known as paracentral scotomas. These black spots in the vision may or may not resolve as the lesions fade. Also, the lesions themselves may never completely disappear.

Etiology/Where does it come from? So what causes these red lesions? Doctors are not sure. AMNR might be somehow linked to one or more of the following:

  • the use of oral contraceptives (birth control medication)
  • an acute viral illness with flu-like symptoms
  • upper respiratory symptoms
  • administration of vasconstricting drugs or epinephrine
  • shock or trauma
  • acute systemic hypotensive episodes

(source 2)(source 3)

What does the Future Hold? The good news is, since AMNR was first reported on by Bos and  Deutman in 1975, the technology for localizing the level of the damaged retina has improved drastically and we are beginning to understand more about this condition. Through the use of OCT and HRT technologies, diagnosis and follow up of AMNR in patients is becoming much easier than it was in the past (since biomicroscopic signs of the illness can sometimes be very subtle). (source 4) There are many recent and ongoing studies of AMNR involving the use of OCT and HRT being conducted as we speak. (source 5) (source 6) Perhaps as technologies and advances in our understanding of AMNR move forward, we will be able to learn even more about AMNR and find ways to treat and prevent it in the near future.

Now it’s time for the first ever Murphy Challenge!

The Murphy Challenge: Can you name five things depicted here (can be adjectives or nouns) that have to do with the above article you just read? Comment me your answers and I will post who gets them right!

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My Studies in Visual Development

My passion for Vision began with research.

 

When I was an undergraduate at SUNY Albany, I remember late nights and early mornings spent happily peering into a microscope. I was fortunate enough to work in the incredible laboratory of Dr. Suzannah Bliss Tieman, who studied neural visual development. Her enthusiasm for her work was infectious and it ignited my then small curiosity in vision into a lifelong passion for learning all I could on the subject.



Under her direction, I examined cross sections of the brain and measured angiogenesis, or blood vessel growth. Using a special computer aided drawing program that was superimposed with the image I was seeing in the oculars of my microscope, I could trace the length of the blood vessels in that slice of brain tissue and calculate their length. I was measuring blood vessels in the specific area of the brain that interprets vision. We were proving that when an eye was deprived of all visual information during its critical period of development, the neural connections in that ‘vision center’ of the brain would also be decreased and underdeveloped. If this part of the brain is underdeveloped, then you may not see as clearly or at as high a resolution as the average person can. You can think of it as the brain not enabling your eyes to see the world with the proper number of “pixels.”



Definition of Amblyopia

 

 

 

A decrease in the best corrected vision, usually in one eye, due to a “disturbance in retinal image formation” (source 1) during the critical period or during the “first ten years of human life.”



The formation of Amblyopia



When your brain and your eyes are first developing, neural connections are formed. These connections will help our brain to interpret what our eyes are seeing as well as the level of detail that they can see. If something reduces the amount of information that the eyes can take in (for example if the eye is aimed off center from where it should be looking), it lessens how much the brain can interpret and decreases the overall number of neural connections in the brain. When the visual areas of the brain are not utilized to their potential, the overall output of the brain is diminished. In other words, if something stops you from seeing great detail when your brain and your eyes are going through their critical period of development, the neural connections that you need in order to achieve good, clear vision may be reduced permanently.* You may not end up seeing 20/20 vision. The good news is, there are, of course, exceptions.

The brain has high plasticity, its “wiring” can be changed, particularly when you are young.*If you ‘exercise’ the eye as directed by your eye doctor, you can strengthen these connections and improve the resolution of your vision. Most doctors say these connections have the best opportunity to be strengthened before about eight years of age. However, there is a chance to improve your best potential vision and re-wire the brain even into your adult years but it would require more time and more intensive therapies.

 

Causes and Treatments


There are different causes for amblyopia, some examples are listed below:

  • strabismus (an eye turn)
  • when one eye has a large amount of uncorrected refractive error (nearsight, farsight or astigmatism) compared to the other eye (blurred input from one eye).
  • a medical condition such as a cataract (blocked/blurred input from one eye)

Treatments for amblyopia include eliminating the cause of the amblyopia and also, strengthening the weaker of the two eyes. Strenghtening the amblyopic eye can be achieved by blocking the sight in the good eye through patching the good eye for a period of time each day or by giving eyedrops such as atropine that temporarily blur only the good eye. This essentially forces the amblyopic eye to seek more visual information, to really pay attention to what it is looking at so it can re-wire and add some new neural connections to the visual area of the brain, making your best potential vision better!

Concluding Thoughts


The brain is an amazing structure. The way it directs and choreographs our body and its development, is even more amazing. To learn more about amblyopia you can click here, and don’t forget to visit your eye doctor. They are happy to answer all of your questions.

Epicanthal folds of an infant or a turned eye, let your eye doctor make the call!

 

If you are a parent, consider bringing your baby into a participating INFANT SEE doctor and receive a eye exam within their first year of life at no charge. Also, any time you are suspicious of problem with your child’s vision or eyes including a possible eye turn or if one or both eyes are not seeing as well as you think they should, bring your child to the eye doctor immediately. As a mother and a doctor I would advise you to, it is always a good thing to have your suspicions checked out. Keep in mind that the younger a patient is when diagnosed with amblyopia, the faster treatment can start and the better their vision will be for life! When in doubt, get it checked out!

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This is a topic I am all too familiar with. I recently suffered my first minor stroke at age 31 but was lucky enough not to have any residual effects left over from it. It was the scariest thing that ever happened to me in my life; to imagine that an otherwise healthy person’s life can be taken away in an instant is terrifying. It all began when I was making my kids their lunch like I do any other day. While preparing it, I noticed a small black spot in my vision that lingered in the lower right hand corner of my visual field. Having a history of ophthalmic migraines and being an optometrist, I self-diagnosed myself as having yet another ophthalmic migraine or eye migraine which is a localized constriction of blood vessels in the head reducing blood flow to the eye temporarily, resulting in a visual distortion (source 1). I went about with my day without thinking much of it. About 10 minutes after I first noticed the spot, other strange things began happening. I was reading my son a book and all of a sudden my ability to read was turned off like a light switch. I could see the pages, the words and the letters but I couldn’t make sense of any of them. It was as if I was trying to read a foreign language. I called my husband to tell him what happened. I thought perhaps I had been poisoned, I must have touched a household cleaner or something toxic and inadvertently ingested it. What else could explain these ‘hallucinations?’

I decided I needed medical attention of some sort and accepted a family member’s offer to drive me to the doctor. I never made it into their car. While getting together my phone, my purse, a wave of nausea swept over me. I felt very dizzy. We called 911. While waiting for the ambulance, some of the more ‘classic’ symptoms of a stroke began. I began to slur my speech, I laid down as the right side of my face and right arm went completely numb. I couldn’t believe all of the things that were happening to me, at first I thought I was poisoned, then knew, all to well through my medical training, those classic symptoms of a stroke and what it meant. It was happening to me. But why? I don’t smoke, I don’t use birth control, I live an active life, I have no other medical conditions, I am healthy, I am young, I don’t do drugs, I hardly even drink. After many tests in the ER and at the hospital, it was found that I have a congenital heart defect called a PFO (patent foramen ovale) that I was completely unaware of.

A PFO is a hole or ‘door’ in the atrial septum, the wall that divides the left and right atrium (upper chambers of the heart). Everyone has this hole when in the womb but usually the hole closes shortly after birth. However, in 10-30% of people, it does not. (source 2) This defect in the atrial-septal wall can act as an open door for blood clots formed in the body to return back to the heart and go straight to the brain, instead of going through the normal filtration and reoxygenation system of the lungs. When a blood clot blocks an artery in the brain and stays there it is called an ischemic stroke. When a blood vessel bursts in the brain, it is called a hemorrhagic stroke. And when a blood clot blocks an artery in the brain temporarily and then ‘moves on’ it is called a TIA (transient ischemic attack) or mini-stroke (source 3). Having a TIA is a warning sign of a future stroke yet to come. (source 4).

It’s important to know the symptoms of a TIA to watch out for. Seek medical attention IMMEDIATELY if you have any of the following. It is  impossible to know if what you are experiencing is a TIA, ischemic stroke or hemorrhagic stroke and proper medical intervention is absolutely needed to protect your health and your life.

SYMPTOMS OF a TIA (source 5):

  • SUDDEN numbness or weakness of face, arm or leg – especially on one side of the body.
  • SUDDEN confusion, trouble speaking or understanding.
  • SUDDEN trouble seeing in one or both eyes.
  • SUDDEN trouble walking, dizziness, loss of balance or coordination.
  • SUDDEN severe headache with no known cause.

Also, you can quickly screen for some common stroke symptoms by remembering FAST which stands for FACE ARMS SPEECH TIME.

ACT FAST=

F ace= Ask person to smile, does one side of their face droop?

A rms= Ask person to raise both arms straight out in front of them, does one arm drift downward?

S peech= Ask the person to repeat a simple sentence, is their speech slurred? can he/she repeat the sentence correctly?

T ime= If the person shows any of these symptoms, it is TIME to act fast, call 911 immediately, get to the hospital fast. Brain cells are dying.

Forty-two days after I had my TIA, I chose to have PFO closure heart surgery. A device was implanted along my atrial septal wall to ‘close the door’ or hole in my heart for good. I find comfort in the fact that this pathway for a clot to travel is now closed and I am hoping to live the rest of my life, stroke-free.

I know this article may have been a little off topic but thank you for allowing me to share my experience with you. I feel that the more I get the word out about what happened to me, the better prepared others will be with the knowledge they may need someday to save the lives of themselves or their loved ones. It can happen to anyone so we all have to know what to watch out for in order to look out for one another.

I also found it interesting that changes in my vision were actually my first warning sign! That little black spot acted like a red flag to me to be on the lookout for any other changes to my body and once other symptoms kicked in, I knew I should take these warnings seriously, thank goodness I did. Vision is a very important part of your life, it can even help save it.

For more information about TIAS you can visit Talk About TIA.

You can also learn more or donate to the National Stroke Association on my personal page.

If you have recently had a TIA and would like to participate in a study to help develop an online questionaire so others can see if their symptoms might be a TIA, click here for the UCSF WebTIA Project.

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Retinoblastoma (RB), although rare, is the most common type of eye cancer in children under the age of five. (source 1) About 300 children and young adults are diagnosed with Retinoblastoma (RB) each year in the United States. (source 2)

Retinoblastoma begins to occur when the eyes are first forming while the child in still in the womb. Specialized cells called retinoblasts divide and begin to fill in the eye to form the sight-seeing tissue that lines the inner eye called the retina. At a certain point, the retinoblasts are  programmed to stop dividing; in the case of retinoblastoma, they do not stop dividing. This uncontrolled cell growth in the retina is Retinoblastoma. (source 3)

RB has been linked to an abnormality in the RB or RB1 gene. This mutation of the RB1 gene is either inherited, congenital (hereditary) retinoblastoma and occurs in every cell in the body (germline mutation), or it can be a new mutation in only one cell, sporadic (non-hereditary) retinoblastoma.

Congenital or hereditary retinoblastoma means that the abnormality in the gene is present at birth and affects all cells in both eyes.  They usually have bilateral retinoblastoma and multifocal tumors. Only 25% of these children inherit the gene abnormality from one of their parents, 75% of the time it occurs for the first time during the early development of the eye while in the womb. (source 3)

Sporadic or non-hereitary retinoblastoma means the mutation is new and occured on its own in one cell of one eye. The reason the one cell mutated while dividing is unknown. The net result is only one tumor in one eye. (source 3)

Retinoblastoma is a life-threatening disease, particularly if the undetected cancer spreads, but due to early detection, raised awareness and appropriate treatments and follow-ups, in the United States, the survival rate is very high, over 90%. (source 4) Yet in order to treat it, you must first detect it. Here are some signs and symptoms of Retinoblastoma. If you see something or suspect anything is wrong with your child’s eyes, schedule an appointment with an eye care professional right away, within one week.

Symptoms  and Signs of Retinoblastoma: (source 5)

  • visible whiteness or reflex in the pupil, particularly when a color photo is taken with a flash (a white reflex can also occur under certain lighting conditions or if the eye is turned 15 degrees toward the nose, in that case you may be getting a white reflection off of the normal optic nerve inside the eye instead of the “red” retina (“red eye”). Only with an examination by an eye care professional can you deteremine if it is a true white pupil (leukocoria) or just an image artifact of the photography.)
  • glint of whiteness behind pupil in dim lighting
  • crossed eyes/turned eye
  • persistent pain or redness
  • poor vision

When in doubt, have it checked out!

Many eye care professionals participate in INFANT SEE, a no cost public health care program which gives you a one time, comprehensive eye exam for your infant under the age of one year at no charge, regardless of income. To find a participating doctor in your area, visit the InfantSee website or call 1-888-396- EYES (3937). In cases where a white pupil is suspected, a pediatric ophtalmologist would be your best option, only because if Retinoblastoma is truly suspected, additional testing such as ultrasound of the eye can be done there to gather further information and time is crucial if it is indeed eye cancer.

Inspiration behind this article:

Photo by C. Murphy; Example of white pupil as artifact of photography; eye normal.

This is a picture of my daughter that I took with a digital camera with flash. Even after using the ‘fix red eye’ feature with photoediting software, the pupil of the right eye appeared white. As an optometrist, I knew of Retinoblastoma and how important it was to have it checked out very quickly. After extensive testing with an pediatric ophtalmologist all was determined to be normal and the white pupil was one of those “one in a million” pictures where the eyes are normal but the lighting hits the eye, lens and retina in such a way that causes a white reflection. As a mother, who would do anything at any time to save my child’s life, I want to help other mothers out there by raising the awareness of Retinoblastoma. Together, let’s make that over 90% survival rate in the U.S. closer to 100% and let’s improve the survival rate worldwide. To learn more, visit the links below and consider making a donation.

Daisy’s Eye Cancer Fund

Retinoblastoma International

A very informative video for doctors on what to do if a child has a white pupil by Dr. Carol Shields, MD, Wills Eye Institute

SPECIAL THANKS TO MY FRIEND, LORI BOLLINGER, FOR POSTING THE DAISY’S EYE CANCER FUND VIDEO AND INTRODUCING ME TO A FRIEND WHOSE DAUGHTER WAS DIAGNOSED WITH RETINOBLASTOMA. I HAD TAKEN THAT PICTURE OF MY DAUGHTER ONE WEEK PRIOR.  I CALLED FOR THE APPOINTMENT FOR MY DAUGHTER IMMEDIATELY AFTERWARD.

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There are several systemic diseases and illnesses that affect not only the health of your body but specifically the health of your eyes. One of the conditions I encounter most when examining patients is diabetes. “Diabetes is a disease in which your blood glucose, or sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. With Type 1 diabetes, your body does not make insulin. With Type 2 diabetes, the more common type, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood.” (source 1) Having an elevated amount of glucose in your blood over a period of time can have devastating effects. It can damage organs such as the eyes, kidneys and nerves and can also put you at greater risk for stroke and heart disease  (source 1).

Once you are diagnosed with Diabetes, you have to be monitored very carefully to ensure that your diabetes is under control and that elevated glucose levels are not causing damage to your eyes. Yearly dilated eye exams are a must with your eye doctor to check for even early signs of diabetic retinopathy. If early warning signs are found, your eye doctor will communicate this to your general physician who will make decisions on how to manage your blood sugar and keep it as close to normal as possible. One of the ways to monitor how well your diabetes is being controlled is by getting bloodwork to test your Hemoglobin A1C levels (A1C levels). The A1C test measures average blood glucose levels for a period of up to 3 months. (source 2) This has been the standard of care for monitoring glucose control in Diabetics but now is also becoming a method of determining if someone is at high risk for developing diabetes in the near future. A diagnosis of Diabetes can be made if your A1C level is 6.5% or higher and an increased risk for Diabetes in the near future can be noted for patients with an A1C of 5.7% to 6.4%. (source 2) 

The American Diabetes Association revised their Diabetes Guidelines for 2010, retinal photography may be helpful in detecting clinically significant diabetic retinopathy but does not take the place of an initial comprehensive eye exam and dilation of pupils. See your eye doctor for this thorough testing upon initial diagnosis of Diabetes and every 12 months thereafter. Your eye doctor may suggest more frequent dilations of the pupils if your glucose levels are not under control. Also, those who are at increased risk for diabetes should be examined as well. This will help establish baseline findings and help your eye doctor to better detect even subtle changes in your eyes over time.

You can see now how knowing the results of your latest bloodwork, specifically, your A1C results, would be a fast and efficient way assessing your risk for Diabetes or, if you know you are diabetic,  how well you are currently being controlled through medications, diet and exercise. Since it spans a period of three months, it gives a better picture of your glucose levels than older methods. You deserve the best quality of care for your eyes and the rest of your body. Take the proactive, preventative approach towards your health, ask your doctor about your A1C number and what else can be done to lower your risk of damage caused by increased glucose.

Here are some statistics on Diabetes from 2007 copied directly from Diabetes.org (source cited below as well) :

“Data from the 2007 National Diabetes Fact Sheet (the most recent year for which data is available)

Total: 23.6 million children and adults in the United States—7.8% of the population—have diabetes.

Diagnosed: 17.9 million people

Undiagnosed: 5.7 million people

Pre-diabetes: 57 million people

New Cases: 1.6 million new cases of diabetes are diagnosed in people aged 20 years and older each year. “

(SOURCE 3)

LOOK AT THE 57 MILLION PEOPLE WHO FALL INTO THE PRE-DIABETES CATEGORY!

Take Charge of your Health today!

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