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Programmable Electronic Glasses Provide Children Effective, Digital Lazy Eye Treatment PDF
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Ophthalmology and Optometry
Friday, 27 November 2015

Electronic GlassesA new study on lazy eye found that programmable electronic glasses help improve vision in children just as well as the more traditional treatment using eye patches. This "digital patch" is the first new effective treatment for lazy eye in half a century. Results from the first U.S. trial of this device have been presented at AAO 2015, the 119th Annual Meeting of the American Academy of Ophthalmology.

Lazy eye, also called amblyopia, remains the most common cause of visual impairment in children. Amblyopia is poor vision in an eye that did not develop normally during early childhood. This can occur when one eye is much more nearsighted than the other, or when one eye wanders or strays inward. The child needs to receive treatment by the age of 8 or so while their eyes and brain are still developing, or he or she could become blind in the weaker eye.

Unfortunately, getting kids to comply with lazy eye treatments like eye patches or medicated drops remains a significant challenge for both ophthalmologists and parents alike. A recent study found that 1 in 4 kids feel anxiety before using eye drops. Nearly 15 percent refuse to take eye drops at all. Both drops and eye patches work based on the occlusion method. This blocks vision in the eye with the best sight, forcing the brain to rely on the so-called lazy eye. During the process, vision improves though many children will still need glasses to correct their eyesight.

In comparison, the electronic glasses used in this study combine vision correction and occlusion. The lenses can be filled to fit a child's vision prescription. Because the lenses are liquid crystal display (LCD), they can also be programmed to turn opaque, occluding vision in the left or right eye for different time intervals, acting like a digital patch that flickers on and off.

Researchers at the Glick Eye Institute at Indiana University recently tested the effectiveness of occlusion glasses compared to patching in a randomized clinical study. They recruited 33 subjects with lazy eye between age 3 and 8 who wore spectacles to correct their vision. One group wore an adhesive patch for two hours daily. The other wore occlusion glasses for 4 hours daily. In the study, the lens over the eye with better vision switched from clear to opaque every 30 seconds. After three months, both groups of children showed the same amount of improvement in the lazy eye, gaining two lines on a reading chart.

"When you talk to adults who underwent childhood treatment for amblyopia, they will tell you that wearing a patch was the worst thing ever," said Daniel Neely, M.D., a pediatric ophthalmology professor at Indiana University who led the study. "With these electronic occlusion glasses, the child learns that the lens will be clear again in just a few seconds so they may be more cooperative with the treatment. For parents who have struggled with drops and patching, this could be a great alternative."

Research Suggests Visual Stress Symptom of Chronic Fatigue Syndrome PDF
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Ophthalmology and Optometry
Thursday, 26 November 2015

Chronic Fatigue SyndromePeople suffering from Chronic Fatigue Syndrome (CFS) could experience higher levels of visual stress than those without the condition, according to new research. CFS, also known as Myalgic Encephalomyelitis (ME), is a condition that causes persistent exhaustion that affects everyday life and doesn't go away with sleep or rest. Diagnosis of the condition is difficult as its symptoms are similar to other illnesses.

A research team from the University of Leicester led by Dr Claire Hutchinson from the Department of Neuroscience, Psychology and Behaviour has examined patients with and without CFS and has found that those suffering from the condition are more vulnerable to pattern-related visual stress, which causes discomfort and exhaustion when viewing repetitive striped patterns, such as when reading text. The results of the study, which is published in the journal Perception, could help in the diagnosis of CFS, as the findings suggest that there are visual system abnormalities in people with ME/CFS that may represent an identifiable and easily measurable behavioural marker of the condition.

Dr Hutchinson explained: “Diagnosis of ME/CFS is controversial. With the exception of disabling fatigue, there are few definitive clinical features of the condition and its core symptoms, overlap with those often prevalent in other conditions. As a result, ME/CFS is often a diagnosis of exclusion, being made as a last resort and possibly after a patient has experienced a series of inappropriate treatments of misdiagnosed disorders.

“It is imperative therefore that research focuses on identifying significant clinical features of CFS/ME with a view to elucidating its underlying pathology and delineating it from other illnesses. Doing so will help researchers and healthcare professionals gain important insights into the condition, aid diagnosis and, in the longer term, inform evidence-based therapeutic interventions.”

The study assessed vulnerability of ME/CFS patients to pattern-related visual stress using a standardised test called the pattern glare test, in which people report the number of visual distortions they experience when looking at three repetitive striped patterns of different levels of detail. During the study twenty patients with CFS and twenty patients without the condition were recruited. Participants viewed 3 patterns, the spatial frequencies (SF) of which were either 0.3 (low-SF), 2.3 (mid-SF) and 9.4 (high-SF) cycles per degree (c/deg). They then reported the number of distortions they experienced when viewing each pattern. Patients with ME/CFS reported more distortions on the intermediate striped pattern (Pattern 2) than people without the condition.

Dr Hutchinson added: “The existence of pattern-related visual stress in ME/CFS may represent an identifiable and easily measurable behavioural marker of ME. This could, in conjunction with other diagnostic tests, help delineate it from other conditions.” Dr Neil Abbot, Research & Operations Director at ME Research UK, said: "Around three-quarters of people with ME/CFS report a range of eye and vision-related symptoms that interfere with their everyday lives, yet there has been very little scientific investigation of the problem. Dr Claire Hutchinson and her team have previously confirmed the existence of eye movement difficulties in ME/CFS patients, and that symptoms, including eye pain, can be severe. Her new report in Perception extends these findings and raises the possibility that vision anomalies, including pattern-related visual stress, may have a diagnostic role in the disease."

Researchers Develop Visual Test To Quickly Check Brain Function Quality PDF
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Ophthalmology and Optometry
Monday, 23 November 2015

BrainU.S. researchers from the University of Georgia have developed a simple technique to measure an individual's visual processing speed—the speed at which an individual can comprehend visual information—in order to identify whether or not they may have cognitive issues.

The recent study, published in the journal Archives of Clinical Neuropsychology, focuses on using a simple test of visual flicker to evaluate an individual's level of executive cognitive abilities, such as shifting attention between different tasks, planning or organizing and problem solving.

For this study, researchers used a method based on measuring processing speed through sight. The device they used tests processing speed by measuring an individual's critical flicker fusion. Participants in the study looked into a device that was created for the purpose of this study. Inside the device, two wavelengths of light would alternate flashing, making it seem as though the light they were looking at was flickering on and off. A participant's critical flicker fusion measure tops out when the flicker is too fast for the participant to see. This flicker measure predicted participants' executive cognitive functioning. Individuals with higher critical flicker fusion also had higher executive functioning.

Researchers also found that results varied based on a participant's age. They tested two age groups-college students, averaging 21 years, and older adults, averaging 72 years. Generally, the older participants had slower visual processing speed, which researchers expected as older adults typically process information more slowly. What separates this study from others is the simplicity and accuracy of the flicker measurements, a researcher said. Critical flicker fusion may tap more basic cognitive processes than other tests traditionally used by researchers.

The brain, not the eye, determines the fastest visual flicker that can be perceived. By measuring critical flicker speeds researchers are able to assess the processing speed of the brain itself, which forms the basis of many higher cognitive functions, such as fluency or memory.

Although this study is still in early stages, it may change the process of future exams when testing for dementia and other cognitive issues.

Medicated Eye Drops Slow Nearsightedness Progression PDF
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Ophthalmology and Optometry
Thursday, 19 November 2015

Eye Drops ChildResearchers say medicated eye drops may be the key to fighting rapidly worsening eyesight in children with myopia. Results from a five-year clinical trial show that drops of low-dose atropine significantly slowed the progression of nearsightedness in children with fewer side effects than higher dosages. The research has been presented at AAO 2015, the 119th annual meeting of the American Academy of Ophthalmology. The findings suggest that this medication could potentially be an effective treatment in the fight against the global surge in nearsightedness.

Nearsightedness, or myopia, has increased dramatically worldwide over the last few decades and remains a leading cause of visual impairment globally. Developed Asian countries report myopia rates of 80 to 90 percent among young adults. While vision can be corrected by glasses or contacts, severe nearsightedness has ramifications that include greater risk of retinal detachment, macular degeneration, premature cataracts and glaucoma.

To help combat this public health issue, investigators in Singapore turned to atropine, a treatment commonly used to treat lazy eye. In this study, which began in 2006, 400 children age 6 to 12 were randomly assigned a daily dose of atropine. Three different groups took drops nightly at concentrations of 0.5, 0.1, or .01 percent for two years. Doctors then stopped the medication for 12 months. For children whose eyes became more myopic during that year off (-0.5 D or more), researchers started another round at 0.01 percent for another two years. The researchers discovered the following key findings:

  • After five years of usage, children using the low-dose 0.01 percent atropine drops were the least myopic when compared to patients treated with higher doses.
  • Atropine eye drops at 0.01 percent slowed myopia progression by an estimated 50 percent compared to children not treated with the medication in an earlier study.
  • Atropine at .01 percent appears to be safe enough to use in children age 6 to 12 for up to five years, though more study is needed. The lower dose caused minimal pupil dilation (less than 1 mm), which minimized light sensitivity experienced at higher concentrations. Patients also experienced minimal near-vision loss with the low-dose drops. 

Atropine inhibits axial growth of the eye associated with nearsightedness. But, the way the medication works remains largely unknown. In addition, the medication has several side effects when given at higher concentrations. For instance, at the concentration used for lazy eye, atropine dilates the pupils. This results in light sensitivity and blurry vision when looking at objects up close. Children taking higher concentrations often need to wear bifocals and sunglasses. In addition, higher concentrations have also caused allergic conjunctivitis and dermatitis.

This trend could change now that much lower doses of atropine appear to offer the similar benefit in reducing nearsightedness progression, without the side effects. The researchers say this latest five-year follow-up study shows the long-term benefits outweigh the risks. However, they emphasize more information will be needed to establish which children are good candidates, as about 9 percent of children in the low-dose group did not respond to the drops in the first two years. More research is also needed to determine when treatment can safely begin and how long the drops should be used. Additional studies on atropine for myopia progression to be conducted in Europe and Japan may help find those answers.

“For a long time we’ve known that atropine drops can help keep myopia from getting worse to some degree,” said Dr. Donald T. Tan, FRCS, FRCOphth, lead investigator and professor of ophthalmology at the Singapore Eye Research Institute and the National Singapore Eye Centre. “We now have data showing that it is not only effective, but also safe. Combined with other interventions, this treatment could become a great ally in preventing myopia from causing serious visual impairment in children worldwide.”

Scientists Develop 'Unbreakable' Glass Almost As Tough As Steel PDF
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Ophthalmology and Optometry
Tuesday, 17 November 2015

New Type of GlassJapanese researchers have developed a new type of glass almost as hard as steel, a breakthrough that could lead to the development of substantially tougher windows and tableware.

"We will establish a way to mass-produce the new material shortly," said Atsunobu Masuno, an assistant professor at the University of Tokyo's Institute of Industrial Science. "We are looking to commercialize the technique within five years."

Oxide glass mainly consists of silicon dioxide, with its strength boosted by mixing in alumina, an oxide of aluminum. But it had been difficult for scientists to form glass containing a large amount of alumina because the oxide causes crystallization when the glass comes into contact with its container. The scientists bypassed this problem by using a containerless processing technique. They used gas to push the chemical components into the air where they synthesized to form the glass. The resultant glass was colorless, transparent and very tough, 50 percent of it being composed of alumina.

The Young's modulus of the new glass, an indicator of rigidity, was twice as high than typical oxide glass and almost at the same level as steel and iron, according to the scientists.

New Study: AMD Could Be Prevented or Delayed PDF
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Ophthalmology and Optometry
Thursday, 12 November 2015

Senior EyeIn a major scientific breakthrough, a drug used to treat Parkinson’s and related diseases may be able to delay or prevent macular degeneration. The findings, published in the American Journal of Medicine, are a groundbreaking effort in the fight against age-related macular degeneration (AMD).  In the study researchers discovered a biological connection between darker pigmented eyes, that are known to be resistant to AMD, and increased levels of a chemical called L-DOPA in those eyes. Since L-DOPA is frequently prescribed for Parkinson’s patients, the researchers wanted to know whether patients who received the drug L-DOPA as treatment for Parkinson’s or other diseases were protected from AMD. By combing through massive databases of medical chart data, they reported that patients receiving L-DOPA were significantly less likely to get AMD, and when they did, its onset was significantly delayed.

“Rather than looking at what might cause AMD, we instead wondered why certain people are protected from AMD. This approach had never been done before,” says senior author Brian McKay of the University of Arizona. The research findings are based off an analysis of the medical records of 37,000 patients at the Marshfield Clinic in Wisconsin. Because the average age of those given L-DOPA is 67, while the average age of AMD diagnosis is 71, scientists were able to effectively track patterns. These major findings were then confirmed by reviewing a data set of 87 million patients. In this large scale data set, L-DOPA also delayed or prevented AMD from progressing to its “wet” form, the most devastating form of the disease.

The next steps for the team of scientists is to launch a clinical trial to further test the ability of this drug to prevent AMD. The title of their research paper is “Mining Retrospective Data for Virtual Prospective Drug Repurposing: L-DOPA and Age-related Macular Degeneration.”

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