Wednesday, April 27, 2011
Friday, April 22, 2011
People with glaucoma could receive a simple injection in the near future to halt - or even reverse - the eye condition.
Scientists at Cambridge University believe the technique, which uses stem cells, could even cure blindness one day.
They have already had success in rats and hope to start trials in humans within five years.
The method involves taking stem cells from bone marrow and injecting them in a solution into the back of the eye.
There, they help existing optic nerve cells from degenerating further. They can also transform theselves into new optic nerve cells, reversing damage and improving eyesight.
Professor Keith Martin, a neuroscientist at Cambridge University and an eye surgeon at Addenbrooke's Hospital, said: "Finding treatments to reverse blindness is no longer in the realm of science fiction.
"We are doing it in animal models and results are so encouraging that we hope to move forward to testing on humans soon.
"Stem cell treatment is moving forward very fast in many branches of the medicine and we are seeing some of the best results in eyes."
He added: "We have concentrated on glaucoma because it is so common, but there are quite a few diseases that affect they optic nerve, such as inflammatory diseases, so it could be used here too."
While the team has had success in halting glaucoma in rats and reversing its decline to some extent, they are still working on the ultimate objective - how to cure blindness.
There are 300,000 people in Britain diagnosed with glaucoma, although the total number of sufferers is thought to be double that. Most are over 40.
The condition is usually caused by raised eye pressure and damage to the optic nerve, which transmits signals from the retina to the brain. The field of vision slowly narrows over years or decades.
Prof Martin said the new technique could help two groups in particular: those diagnosed with advanced glaucoma and those who developed it early in life.
The existing treatment, lowering eye pressure, worked well for most people but as it was a preventative strategy it was useless for those with advanced glaucoma, he said. In addition, lowering eye pressure alone could not stave off glaucoma over many decades.
The project is funded by a £320,000 grant from charity Fight for Sight, which is supporting today's (SAT) World Glaucoma Day.
Dr Dolores Conroy, research officer for Fight for Sight, said: "Advances in stem cell technology are likely to revolutionise treatments for diseases like glaucoma.
"We must invest in this research field now so treatments to save, and potentially restore, the sight of millions of people are available in the future."
Wednesday, April 13, 2011
Acupuncture Might Treat Certain Kind of Lazy Eye Small Chinese study found it worked better than an eye patch in older kids with condition
By Alan Mozes
MONDAY, Dec. 13 (HealthDay News) -- Acupuncture may be an effective way to treat older children struggling with a certain form of lazy eye, new research from China suggests, although experts say more studies are needed.
Lazy eye (amblyopia) is essentially a state of miscommunication between the brain and the eyes, resulting in the favoring of one eye over the other, according to the National Eye Institute.
The study authors noted that anywhere from less than 1 percent to 5 percent of people worldwide are affected with the condition. Of those, between one third and one half have a type of lazy eye known as anisometropia, which is caused by a difference in the degree of nearsightedness or farsightedness between the two eyes.
Standard treatment for children involves eyeglasses or contact lens designed to correct focus issues. However, while this approach is often successful in younger children (between the ages of 3 and 7), it is successful among only about a third of older children (between the ages of 7 and 12).
For the latter group, doctors will often place a patch over the "good" eye temporarily in addition to eyeglasses, and treatment success is typically achieved in two-thirds of cases.
Children, however, often have trouble adhering to patch therapy, the treatment can bring emotional issues for some and a reverse form of lazy eye can also take root, the researchers said.
Study author Dr. Dennis S.C. Lam, from the department of ophthalmology and visual sciences and Institute of Chinese Medicine at the Joint Shantou International Eye Center of Shantou University and Chinese University of Hong Kong, and his colleagues report their observations in the December issue of the Archives of Ophthalmology.
In the search for a better option than patch therapy, Lam and his associates set out to explore the potential benefits of acupuncture, noting that it has been used to treat dry eye and myopia.
Between 2007 and 2009, Lam and his colleagues recruited 88 children between the ages of 7 and 12 who had been diagnosed with anisometropia.
About half the children were treated five times a week with acupuncture, targeting five specific acupuncture needle insertion points (located at the top of the head and the eyebrow region, as well as the legs and hands). The other half were given two hours a day of patch therapy, combined with a minimum of one hour per day of near-vision exercises such as reading.
After about four months of treatment, the research team found that overall visual acuity improved markedly more among the acupuncture group relative to the patch group. In fact, they noted that while lazy eye was successfully treated in nearly 42 percent of the acupuncture patients, that figure dropped to less than 17 percent among the patch patients.
Neither treatment prompted significant side effects, the authors said.
The team nonetheless pointed out that their study's tracking period was relatively short, and that acupuncture is a complicated system that may lend itself to different success rates, depending on the skills of the particular acupuncturist.
And while theorizing that the apparent success of this alternative approach may have something to do with stimulating blood flow, retinal nerve growth and visual cortex activity, the authors acknowledged that the exact mechanism by which it works remains poorly understood.
Dr. Richard Bensinger, a Seattle-based ophthalmologist and spokesman for the American Academy of Ophthalmology, said that the finding is "certainly suggestive and worth following up."
"This is kind of cool," he said. "But I will say that I don't know of any study looking at acupuncture and vision. There are studies based on symptomatic things such as pain, and I think there's pretty good evidence that it does have benefit in that respect. But for vision therapy this is the first I've heard of it, and I don't know that anyone has ever tried this before. So this is like a teaser."
"Of course people in those parts of the country, like where I live, where there's fairly wide acceptance of alternative medicine might receive this type of treatment better than others," Bensinger cautioned. "And no question patients will gravitate towards treatments that are covered by their insurance even if it's not the best treatment. And as an alternative approach, this may not be covered."
"But if it works," he added, "people will certainly be excited -- although it certainly needs further testing and further studies to decide if it's really beneficial or not."
For his part, Dr. Stanley Chang, chairman of the ophthalmology department at Columbia University in New York City, did not seem to hold out much promise for acupuncture's potential as an alternative lazy eye therapy.
"Acupuncture I think definitely works for pain amelioration, but I'm not sure it works for some of these other things," he cautioned. "They've tried it for the treatment of myopia and glaucoma, without much success. And so although there haven't been any really good trials comparing acupuncture with conventional therapies, my guess is that it's probably not going to do much for the treatment of lazy eye."
"However, I think it's worth considering or trying," Chang added, "because nothing else seems to work very well for patients of that age, including patch therapy. But what will need is a very carefully controlled study that accounts for all the variables that might have an impact on the outcome of this approach."
For more on amblyopia, visit the National Eye Institute.
SOURCES: Dennis S.C. Lam, M.D., department of ophthalmology and visual sciences and Institute of Chinese Medicine, Joint Shantou International Eye Center of Shantou University and Chinese University of Hong Kong; Richard Bensinger, M.D., Seattle ophthalmologist, and spokesman, American Academy of Ophthalmology; December 2010 Archives of of Ophthalmology.
Last Updated: Dec. 13, 2010
Copyright © 2010 HealthDay. All rights reserved.
Wednesday, April 6, 2011
By Matthew Barakat, Associated Press
FALLS CHURCH, Va. — Some people call them floaters. Eye doctors call them "vitreous opacities." Emily Flynn of Dunedin, New Zealand, called hers "a little fuzzball." She flew halfway around the world to have it removed.
After more than 100 pinpoint zaps from a laser beam during a half-hour visit to a northern Virginia office park, the fuzzball was gone, obliterated within the clear, gelatinous goo that fills the eyeball.
The surgeon, John Karickhoff, has done the same procedure more than 1,400 times over the past 15 years and claims a success rate of better than 90%, with minimal risk of complications. Still, many ophthalmologists have never heard of the procedure — and most would recommend against it. The procedure has drawn regulatory scrutiny in Florida.
Nearly everybody has floaters or will develop them at some point in life, especially older and nearsighted people. Sometimes shaped like specks or snakes, they float through a person's field of vision, and are most easily seen when you look against a light background like a blue sky or a white wall.
They are harmless, usually just bits of membrane that have become dislodged from other parts of the eye. Karickhoff estimated that 95% of people who have floaters ought to leave them alone. But for that 5%, they can be a legitimate problem.
"I've had musicians who couldn't read the sheet music quickly enough because the floater would get in the way," said Karickhoff, who has tried for years to get the procedure accepted into the medical mainstream. "It can ruin a patient's quality of life."
Only a handful of doctors in the United States — perhaps as few as two — regularly treat floaters with laser surgery.
"Patients usually are told to learn to live with it," Karickhoff said. "By the time they come to see me, they've already seen two or three other doctors."
Richard Bensinger, a spokesman for the American Academy of Ophthalmology, said most ophthalmologists believe the procedure is unnecessary. He acknowledged the laser treatment is often successful and carries little risk, but most doctors believe any risk is unacceptable for treating a benign condition like floaters.
If patients insist on treatment, Bensinger said the laser treatment can be a better choice than the more common alternative, a vitrectomy, which involves removing most or all of the eyeball's internal fluid.
The vast majority of patients can learn to live with floaters, Bensinger said. Those patients who demand treatment, he said, "are mostly obsessive-compulsive types" who allow the floaters to drive them to distraction.
But Oliver Hill, 60, of Waynesburg, Pa., said many eye doctors are too dismissive of how irritating a floater can be. He compared it to trying to read a book while holding a pencil directly in front of one of your eyes.
"It just drove me right up the wall," said Hill, who had his left eye treated in June 2005 and returned to Karickhoff in November to treat a floater in his right eye.
In Flynn's case, her optometrist in New Zealand had told her that floaters were common and not harmful, and that she should learn to live with it. She learned about Karickhoff from his website.
Before having the surgery, Flynn said she would get headaches as she read and often tried to read with one eye shut to keep the floater out of her line of sight.
"That eye was effectively dysfunctional," Flynn said.
Karickhoff said he knows firsthand that floaters can be troubling — he had what he called "a whopper" of a floater in his own eye.
He was skeptical when, on a Florida vacation, he saw a newspaper ad touting laser surgery for floaters. But he sat in on a surgery performed by Fort Myers ophthalmologist Scott Geller and later allowed Geller to operate on his eye. The procedure was a success.
Not long after, Karickhoff began performing the procedure himself. Both Geller and Karickhoff have since operated on thousands of patients.
Last year, the Florida Board of Medicine investigated a complaint against Geller filed by a 72-year-old woman who complained that the surgery merely broke up one large floater into a bunch of smaller floaters. But the board dismissed the complaint after hearing testimony from Karickhoff on how the procedure works.
Karickhoff, who has a clean record with the Virginia medical board, said he can tell by examining the patient's eye if the floater is a serious distraction or a minor annoyance. He declines to treat those "who are making a mountain out of a mole hill" because such patients will almost never be satisfied.
There is little peer-reviewed literature about the procedure. What does exist shows the procedure to be generally safe, but the results about its effectiveness are mixed.
Karickhoff said studies have not replicated his success rate because they have not fully emulated his technique, which requires a laser beam of a specific intensity, and because they have not always chosen ideal candidates for surgery.
Karickhoff said there is a theoretical risk of serious complications, including a detached retina, but that he has never seen it happen. He said his own rate of complications is about a tenth of a percent, usually involving increased pressure within the eye.
Geller likened laser treatment of floaters to "an orphaned surgical procedure" that has been unable to overcome entrenched skepticism.
Despite that skepticism, Karickhoff said the medical community has not been completely unresponsive. He has written a medical book about the procedure, and said he received mostly positive feedback when he presented his work in November at the national conference of the American Academy of Ophthalmology. And insurers frequently cover the procedure, he said.
Manfred von Fricken, chief of ophthalmology at Inova Fairfax Hospital,said he has seen many of Karickhoff's patients who have benefited from the surgery.
"It's an innovative approach," said von Fricken, who agrees that eye doctors are too often dismissive of patient complaints about floaters. "He's thinking out of the box, and I think it's pretty imaginative."
For more information about Dr. Karickhoff's treatment, visit his website at: