The cheap reading glasses that can damage your sight

By Sean Poulter
Last updated at 1:08 AM on 31st October 2010

They may save you money in the short term but cheap reading glasses could end up costing your eyesight.

The so-called ‘ready readers’, which sell for as little as £1 in high street shops, may leave wearers with eye strain, headaches or even blurred or double vision.
Millions have bought them after baulking at the high cost of buying glasses from an optician.

However, research suggests they could be putting their eyesight and health at risk.
By the age of 50, most adults have problems reading a book or newspaper without spectacles.
So the arrival of the cheap glasses in supermarkets, high street stores and market stalls less than ten years ago has been seen as a saviour for many

A consumer might have to pay more than £100 for a pair of reading glasses from an optician, which might easily be lost or broken.

Instead, many buy several cheap versions to stash around the house so that they can always find a pair.

A researcher at consumer champion Which? checked 14 pairs from seven high street chains.
He found problems with half of them, with those carrying a higher prescription – +3.5 to +4 – considered to cause the most concern. ‘Off-the-peg glasses could cause eye strain, blurred vision, headaches or double vision,’ the Which? researcher said.

‘For people with higher prescriptions, they’re not suitable for walking or other mobile activities.’
They could even ‘cause a nasty accident’, he warned.

The biggest problem is that the centre point of the two lenses might not be aligned.

This means the sight in one eye might be clear while the other is blurred. This was the case in a pair from Poundland – which also had a prescription strength that differed from the +3.5 on the pack – and a £16 pair from fashion eyewear store Sight Station.

‘This could cause eye problems or a head tilt,’ the researcher said.

A £4 pair from Tiger were ‘unwearable’ because the centre point of the lenses did not match, while a £2 pair from Primark had ‘a very large difference’.
A £15 pair from Marks & Spencer were so ‘poorly made’ that the lenses were likely to drop out.
Which? advises people who have a prescription above +2 to test reading glasses for two minutes to check the centre points of each lens are aligned correctly.

Opticians say eye examinations are essential before buying glasses.

As well as ensuring the correct prescription is used, they can detect serious health issues, such as cataracts and brain tumours.

Can Boomers Throw Away Their Reading Glasses?

By John Gever, Senior Editor, MedPage Today
Published: October 25, 2010
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

CHICAGO -- With the baby-boom generation now firmly in the age range when near-range vision goes blurry, advances in refractive surgery and implants could allow many of them to do away with reading glasses, researchers said here.

A series of presentations at the American Academy of Ophthalmology's annual meeting indicated that new types of intracorneal implants and LASIK-like procedures show promise for eliminating presbyopia, the progressive deterioration of near vision that afflicts virtually everyone older than 45.

Among the innovations highlighted at the meeting: a doughnut-shaped corrective lens inserted under the cornea; a thin disk that restricts the pupillary opening, improving depth of focus in the same way as a pinhole camera; and a noninvasive, implant-free laser procedure that cuts concentric rings in the corneal stroma to alter its refractive power.
None of these are yet approved by the FDA.

At a press briefing, Gustavo Tamayo, MD, of the Bogota Laser Refractive Institute in Bogota, Colombia, described in broad strokes the procedures that are available in South America and Europe, which can target the cornea, the sclera, the anterior chamber, or the lens itself.

Many procedures are owned and developed by U.S. companies, though, and eventual FDA approval is expected. Several of these were the focus of scientific presentations at the AAO meeting, including a report from one U.S. clinical trial.

Intracorneal lens

Ioannis Pallikaris, MD, of the University of Crete in Greece, discussed a recent one-year clinical study with an intracorneal bifocal lens called Flexivue.

The implant has a hole in the center, not as part of its refractive design but to aid in centering it over the pupil.

Session discussant Karl Stonecipher, MD, of TLC Laser Eye Center in Greensboro, N.C., noted that "centration" is a major issue for all types of refractive alteration intended to assist the natural lens -- vision will be imperfect and sometimes worse than before if the corrective intervention is even slightly out of alignment with the lens.

Pallikaris said the lens is 20 microns thick and 3 mm in diameter and is inserted into a pocket created within the stroma with a femtosecond laser.

He reported data on 15 patients with a mean age of 51 receiving the implant -- one per patient in the nondominant eye.

Mean baseline near-vision acuity was 20/50. Within one week of the implant, it improved to 20/32, settling at 20/25 by the third month where it remained for the full year of follow-up in the study.

The bifocal lens also provides a focal point for distance vision, to compensate for the impairment of distance vision that otherwise would result from an anti-presbyopic change in corneal refraction.

In the implanted eye, mean uncorrected distance-vision acuity dropped from 20/20 at baseline to 20/40 during the first month, and then recovered to 20/30 at six months.

Pallikaris noted, though, that uncorrected binocular distance vision remained perfect throughout the entire study, because the artificial lens is placed only in the nondominant eye.

He reported that all of the patients reported their uncorrected near vision after the procedure was excellent or good, and 92% had stopped all use of reading glasses.

Light-restricting disk

Another approach alters the eye's optics not with a lens but with a small disk that reduces the effective pupillary diameter to create a pinhole effect.

Daniel Durrie, MD, of the University of Kansas Medical Center and DurrieVision in Overland Park, Kan., explained that the concept is similar to the F-stop setting of a camera that opens and closes the lens aperture.

A small aperture setting increases the so-called depth of field, such that objects both near and far are in focus. Consequently, this product does not impair distance vision and could actually improve it.

He is leading U.S. testing of the implant, called AcuFocus, which in its current version (the third to date) cuts the effective pupillary diameter from about 4 mm under indoor artificial light to 1.6 mm. The reduction in light transmission is 95%.

As with the Flexivue lens, it's implanted in only one eye. Durrie told MedPage Today that patients do notice that the reduction in light transmission, but it doesn't diminish their overall binocular vision.

The disk also contains 8,400 tiny holes, 5 to 11 microns each, to allow ocular fluids to pass back and forth across the implant to anterior tissues.

Durrie said the implant can be placed under a corneal flap or in a pocket. He said he prefers a flap because it eases positioning and removal, if necessary.

He reported three-year follow-up data from 163 patients receiving two earlier versions of the implant, which were somewhat thicker, with a larger aperture (restricting light by 89% and 93%) and fewer, larger holes for fluid porosity.

Unlike the Flexivue lens and other approaches that change the cornea's refractive properties, the Acufocus lens had almost no impact on the distance acuity, Durrie said.

Among 44 patients receiving the product's first version, the average uncorrected near-vision grade was J2 and mean uncorrected distance vision was 20/25.

The second version, which had a smaller aperture than the first, produced mean uncorrected distance vision of 20/20 and an uncorrected near-vision grade of J1 in 119 patients.

Durrie said a U.S. clinical trial with the third version is now under way in 504 patients. The product is already marketed in Europe and Asia, he said.

He indicated that the disk, at least currently, is not color-matched to the patient's iris and therefore is visible in some patients, especially those with blue eyes. He indicated that one patient didn't like the cosmetic effect and demanded the implant's removal.

Laser-etched rings

A third approach is somewhat similar to laser keratotomy, except that it uses a femtosecond laser to make concentric circular cuts in the stroma.

Mike Holzer, MD, of the University of Heidelberg in Germany, said that procedure takes just 20 seconds once everything is set up.

The arrangement of the rings and the stromal depth can be adjusted to achieve the desired refractive correction, he said.

He also noted that it does not involve any incisions in eye's surface, virtually eliminating infection risk.

He described results in 25 patients with a mean age of 56 treated in mid-2008, with up to 24 months of follow-up available.

At baseline, the patients had uncorrected near vision of 0.70 logMAR units (SD 0.16), equivalent to about 20/100.

Three months after treatment, their mean near-vision acuity had improved to 0.20 logMAR units, or about 20/30, Holzer said.

At 12 months, the mean value worsened slightly to 0.30 logMAR, but among patients evaluable at 18 and 24 months, it was back to 0.20.

Most patients evaluated at 24 months had gained five to six lines of uncorrected near acuity on a standard chart relative to baseline, Holzer said, allowing them to read newspapers held at a normal distance without reading glasses.

He noted that the procedure does induce a degree of myopia for distance vision. "The ideal patient should be a little bit hyperopic [at baseline]," he said.

However, there was no diminution of middle-distance acuity, he added.

At the press briefing, Richard Lindstrom, MD, of Minnesota Eye Consultants in Bloomington, Minn., discussed still other approaches involving the lens -- either replacing it entirely with a multifocal synthetic lens as part of cataract surgery, or implanting a so-called phakic intraocular lens that rests on top of the natural lens.

These also are largely development-stage products in the U.S., though they are marketed elsewhere in the world.

Lindstrom said a major consideration for all these treatments is the limited reimbursement available from third-party payers.

He noted that Medicare has ruled out payment for surgeries and implants for acuity problems that could be corrected with glasses, and private insurers have largely followed suit.

Consequently, at least for the near future, baby boomers facing combination problems such as cataracts, myopia, and presbyopia will have to pay for these do-it-all procedures out of pocket.

Lindstrom said such patients therefore have a decision to make, regarding how much they're willing to pay for uncorrected perfect vision versus settling for cheaper procedures that correct some problems but still leave them needing glasses or contact lenses for driving or reading restaurant menus.

Mayo Clinic guide: Home remedies can do the trick

By Janice Lloyd, USA TODAY

In this age of rising medical costs and growing demands on our time, a trip to the doctor is something we hope to avoid.
But how do you keep yourself healthy enough to stay away? And how do you know what illnesses you can treat at home and which need professional attention?

Enter the Mayo Clinic's Book of Home Remedies, a 200-page guide for treating more than 100 common conditions. Savvy parents looking for quick advice and good bedside manner get both from author Philip Hagen, who discusses alternative and conventional approaches to healing, cautions about when to seek medical help and offers advice about how to stay healthy.

"This book reflects our experience in working with people who come to the doctor when there may be something that they can do at home," says Hagen, who specializes in internal and preventive medicine.

"We looked at conditions that had a broad impact on the population for which there seemed to be some reasonable home remedies. Then we asked the experts at Mayo to see if there might be reasonable scientific explanations for them and to determine that they're safe."

The need for families to stretch dollars wasn't overlooked by Hagen and his colleagues at Mayo. "The timeliness of this book is in no small part brought about by increasing medical costs," Hagen says.

The kinds of remedies addressed are as diverse as gentle stretching for back pain, swallowing a teaspoon of sugar for hiccups, trying ginger for morning sickness and using Tylenol for teething. And there are instructions for performing lifesaving moves such as CPR and the Heimlich maneuver.

Allergies

"The best way to approach managing allergies is to know and avoid your allergy triggers," Hagen says.

The most common allergens are inhaled — such as pollen, dust, mold and pet dander. At this time of year, when weed pollen is at its worst, people sensitive to pollen can be particularly miserable. He advises:

•Close windows and doors.

•Don't hang laundry outdoors.

•Use an allergy-grade filter on your heating system.

•Rinse out your sinuses with a nasal lavage.

Insomnia

Insomnia disturbs more than one-third of adults at some point, Hagen says. He suggests lifestyle changes — including getting exercise and taking a warm bath one to two hours before bedtime — before resolving to find other ways (antihistamines, sleeping pills) to improve sleep.

•Try gentle exercise like stretching to relax.

•Take a warm bath one to two hours before bedtime.

•Limit naps to 20 or 30 minutes.

Heartburn

Prevention is the key. If you can follow the drill, you won't need a remedy. Still get hit with heartburn? Over-the-counter remedies such as antacids and Pepcid will help.

•Maintain a healthy weight.

•Avoid food and drink that can trigger heartburn. These include fatty foods, alcohol, peppermint and tomato products.

•Don't eat two to three hours before bed.

Influenza

If you get the flu, rest, drink plenty of fluids, try chicken soup — which the authors say helps break up sinus congestion — and consider pain relievers, "but remember, they only make you feel better and can have side effects." Best to take preventive steps:

•Get a flu shot in October or November.

•Wash your hands.

•Eat right and sleep tight.

Heavy Smoking Linked to Alzheimer's in Study

Risk soars for those puffing more than two packs a day, researchers say

By Steven Reinberg
HealthDay Reporter


MONDAY, Oct. 25 (HealthDay News) -- Heavy smoking in middle age seems to increase the risk for developing Alzheimer's disease or another dementia, a large new study suggests.

"We found that people who reported heavy smoking in midlife had more than a 100 percent increase in risk of Alzheimer's disease and vascular dementia," said lead researcher Rachel A. Whitmer, a research scientist in Kaiser Permanente's Division of Research in Oakland, Calif.

"We have known that smoking is a risk factor for cancer, stroke and cardiovascular disease," she said. "This adds to the evidence that what is bad for the heart is bad for the brain."

The report is published in the Oct. 25 online edition of the Archives of Internal Medicine.

For the study, Whitmer's group collected data on 21,123 ethnically diverse people in the Kaiser Permanente health care system who were surveyed between 1978 and 1985, when they were 50 to 60 years old.

During an average follow-up of 23 years, the researchers found that 25.4 percent were diagnosed with dementia, including Alzheimer's (1,136 people) or vascular dementia (416 people), which is the second most common form of dementia after Alzheimer's disease. Vascular dementia is caused by damage to the arteries in the brain.

Compared with non-smokers, those who smoked more than two packs of cigarettes a day in midlife had a "dramatic increase" in the incidence of dementia -- more than a 157 percent increased risk of developing Alzheimer's disease and a 172 percent increased risk of developing vascular dementia, Whitmer's team found.

Former smokers and people who smoked less than half a pack a day did not appear to be at increased risk of Alzheimer's or vascular dementia, the researchers note.

The associations between smoking and dementia did not change even after adjusting for race or gender, high blood pressure, high cholesterol or heart attack, stroke or weight, they add.

A link between Alzheimer's and smoking has been shown before, but this new study pinpoints the specific risk for middle-age smokers for developing both Alzheimer's and vascular dementia, the researchers say.

Smoking, an established risk factor for stroke, may contribute to the likelihood of vascular dementia by causing small clots in the brain. Smoking also contributes to oxidative stress and inflammation, which may be linked to the risk of developing Alzheimer's disease, the researchers say.

"The brain is not immune to long-term damage from smoking," Whitmer said.

Two smaller studies of predominantly white participants also suggested that mid-life smoking raised the risk of developing Alzheimer's, researchers noted.

Commenting on the new study, William Thies, chief medical and scientific officer at the Alzheimer's Association, said "this is a sound confirmation of something that's been known for a while."

Another expert, Dr. Samuel E. Gandy, the Mount Sinai Professor of Alzheimer's Disease Research at Mount Sinai School of Medicine in New York City, said the findings are promising.

"Environmental factors in Alzheimer's disease have been long sought, and, until now, only head injury has emerged," Gandy said. "Unlike head injury, a tobacco smoking association is especially important because that is a risk that can be modified."

Vitamin A pill 'could save the sight of millions as they get older'

By Fiona Macrae
Last updated at 2:07 AM on 18th October 2010

A drug based on vitamin A could prevent millions from going blind as they get older, doctors believe.

The treatment was able to stop the most common cause of blindness in old age during trials.

Researchers behind the drug, fenretinide, found it halted the advance of age-related macular degeneration, for which there is currently no cure.

They targeted the most prevalent form of the condition, known as ‘dry’ AMD, which is caused by the deterioration and death of cells in the macula – the part of the retina used to see straight ahead.

The disease robs sufferers of their sight by creating a blackspot in the centre of their vision.

It can make it impossible to carry out everyday tasks such as reading, driving and watching television.

While the less common ‘wet’ form can be treated, nothing can be done to help the bulk of patients.

The U.S. research studied fenretinide, which is derived from vitamin A, the vitamin found in carrots, and which was originally designed to tackle arthritis.

Almost 250 men and women with dry AMD took a fenretinide pill a day or a placebo.

In the highest dose, the drug halted visual deterioration after a year. This suggests that while it was unable to do anything to stop cells that were already damaged from dying, it protected healthy cells. Although the research is still preliminary, it offers promise of a treatment for the disease.

It affects millions across the world and 300,000 Britons. The number of UK sufferers could more than treble to one million within 25 years as the population ages.

Dr Jason Slakter, of New York University School of Medicine, said: ‘There are currently no effective treatments for dry AMD and the need for finding one is grave.

‘Our study wasn’t designed to give a final answer.

‘It was designed to see if there was a biological effect and if the drug was working in the way we’d expect and to find out if it was well tolerated by patents.

‘I think we answered all of these points favourably. The bottom line is that I am excited about doing more studies.’

Further, larger trials are planned for the end of next year.

If the drug lives up to its initial promise, it could be in widespread use for dry AMD by 2015.

The treatment works because in normal circumstances the eye needs vitamin A to help it see. The retina naturally uses the vitamin and is helped to do so by a compound called retinol binding protein, or RBP.

However in some patients, the vitamin can produce poisons that kill the delicate cells, leading to loss of vision.

Fenretinide acts as a decoy, attaching itself to the RBP and stopping vitamin A from causing harm, the American Academy of Ophthalmology’s annual conference heard.

Wet AMD, in which tiny blood vessels bleed into the retina, is less common, but progresses more rapidly, with central vision being lost within months of diagnosis.

Caught early enough, wet AMD can be stopped in its tracks by a technique called photodynamic therapy, which uses a light-activated dye to destroy abnormal blood vessels. Drug treatments are also available.

Fenretinide also halved the odds of the patients, who already had dry AMD, going on to develop wet AMD.

A spokesman for the research team said: ‘Years of use of fenretinide to treat cancers, rheumatoid arthritis have shown it to be safe and well-tolerated.’

Researchers Say "Poppers" May Damage Eyes.

Not yet clear how widespread these cases might be, experts say

By Alan Mozes
HealthDay Reporter

WEDNESDAY, Oct. 13 (HealthDay News) -- The legal recreational drugs known as "poppers" appear to be linked to light sensitivity and vision loss in at least several healthy individuals, a new French review of cases reveals.

Poppers -- a catch-all term for alkyl nitrites that are often inhaled by partyers for a brief "head rush" and to increase sexual arousal -- may compromise the normal workings of photoreceptor cells found in a key region of the eye's retina, the researchers say.

"We believe that in fact this complication is quite common," said Dr. Michel Paques of the Quinze-Vingts National Hospital in Paris. However, early data suggests that "only a minority of [affected] consumers will show up to the ophthalmologist," he added. That's because popper-related retinal damage may not noticeably affect vision in some cases and may therefore go undiagnosed, he said.

Paques and his colleagues report their observations, based on four patients, in a correspondence to the Oct. 14 issue of the New England Journal of Medicine.

Popular for decades particularly among the gay community, poppers are perceived by many as being relatively safe. They are typically sold over the counter in small bottles.

But nitric oxide is known to affect the metabolism of photoreceptors, the authors note, and can also alter the operation of a key enzyme involved in photoreceptor function.

The authors report on four recent cases, which took place earlier this year within a three-month period.

In one instance, a 27-year old woman experienced eye trouble the day after she inhaled poppers (and drank alcohol) at a party. After 11 days of seeing a "central bright dot" in both of her eyes, she sought medical attention.

An exam turned up no prior history of significant health or eye problems. But her eyesight was found to be less than ideal -- 20/50 in the right eye and 20/40 in the left eye -- and she had a yellow dot on the foveal portion of her eyes, alongside damage to the outer photoreceptor segment of both eyes.

The fovea facilitates the sharp central vision needed for reading, driving, and viewing movies.

One month later, her visual symptoms and physical damage remained unchanged, the research team noted.

Over the following three months, three more patients sought care for similar visual symptoms arising after popper use. Although symptoms did not appear to worsen over time, the researchers noted that just two of the four patients have fully recovered. Meanwhile, the exact underlying mechanics of the apparent poppers-vision risk connection remains unclear.

"Those who did stop taking poppers showed progressive recovery over several months," Paques said.

Before these patients sought treatment, the authors note that only two similar cases had been reported over the prior decade. However, Paques said the occurrence may not be as rare as it seems.

"Since our initial (report) we actively searched for new cases and were surprised to find many of them, sometimes not diagnosed by previous ophthalmologists because the retinal abnormalities are in a small -- yet very important -- area of the retina," he said.

Based on their findings, Paques and colleagues advise eye doctors and potential users of poppers to be aware of the potential risk for popper-related retinal toxicity.

"Even a single dose of poppers may affect the retina," he cautioned. Patients should visit an eye doctor "if there are any symptoms such as bright light in the center of the visual field, or if there is persistent visual loss, for instance, difficulty in reading small letters."

Not all eye specialists are alarmed, however. Dr. Richard Bensinger, a Seattle-based ophthalmologist and spokesman for the American Academy of Ophthalmology, said evidence to date appears to be entirely anecdotal and does not yet suggest a clear cause-and-effect between poppers and vision trouble.

"We have no real detailed history," he noted. "It's just these patients reporting what they had done, and it certainly does sound like there was something in their activity that caused a problem, but it's not necessarily poppers that cause the problem. Because many, many people have taken them all over the planet without any visual incident."

Perhaps the poppers were adulterated in some way, he suggested. "We don't know. So it's worth looking into further," he said.

Kids Playing With Laser Pointers May Be Aiming for Eye Trouble

Teen boy damages retina with Internet-purchased 'toy,' doctors say

By Serena Gordon
HealthDay Reporter

WEDNESDAY, Sept. 8 (HealthDay News) -- A 15-year-old Swiss boy attempted to create his own laser show using a laser pointer he bought on the Internet and a mirror. Instead, he inadvertently beamed the laser into his eyes, creating permanent damage to his vision.

"These high-power laser products are very dangerous," said Dr. Martin Schmid, head of the retina unit in the department of ophthalmology at Lucerne Cantonal Hospital in Switzerland. Schmid is also one of the authors of the case report detailing the young boy's eye damage in a letter in the Sept. 9 issue of the New England Journal of Medicine.

Schmid said that part of the problem is that not all laser pointers are labeled properly, so it's not always easy to know if you have a pointer that could create serious damage. One sure way to know if you have a potentially dangerous laser pointer is if the laser can burn through paper, explained Schmid.

"Every laser pointer which is capable of burning holes into paper or of lighting matches or of popping balloons is highly dangerous for the eye and must not be used by non-professionals," he cautioned.

Those are exactly some of the uses the Swiss youngster was planning for his laser pointer. He told doctors that he purchased the laser pointer so that he could pop balloons from a distance, burn holes in paper cards and burn holes in his sister's sneakers.

While he was attempting his "laser light show," the teen said that the laser beam hit his eyes several times. Although he immediately noticed that his vision was blurry, he was afraid to tell his parents what had happened. He waited two weeks before letting them know that he was still experiencing blurred vision.

The vision in his left eye was so damaged that he couldn't count how many fingers a doctor was holding up until they were just three feet away. His visual acuity in his right eye was 20/50.

Schmid said the boy wasn't sure if the laser was dangerous, and he definitely didn't know it could cause immediate eye injury.

When the teenager's eyes were examined, doctors discovered that there had been significant internal bleeding in the left eye and that there were several small scars in the right eye. Even with treatment, there's still a scar that diminished the boy's vision in his left eye. However, his visual acuity has returned to near normal, according to the report.

The laser used by the boy produced an output of 150 milliwatts (mW), far above the maximal output of 5 mW that's expected from a laser pointer sold to the public. The authors point out that it's possible to purchase laser pointers as strong as 700 mW, although such a device may not look any different than a lower-powered device.

Additionally, Schmid said there are instructions available over the Internet for turning low-power devices into high-powered ones.

And, the authors pointed out, high-powered laser pointers can produce immediate and severe retinal injury -- so severe that even blindness can occur.

Dr. Roy Chuck, chair of ophthalmology and visual sciences at Montefiore Medical Center and the Albert Einstein College of Medicine in New York City, said, "We've seen lots of cases of laser burns, usually from researchers giving presentations, but now we're seeing more cases of people ordering these products over the Internet, though eye injuries in lay people are still pretty rare."

Chuck said that children shouldn't have access to laser pointers. "They're not giving presentations, so why would they need to have them?" He said that when it comes to laser toys -- like those used for laser tag -- buying a well-known name brand may be helpful in this case. "When you're buying off the Internet, it's not as regulated and you just can't tell what the strength of the laser is," noted Chuck.

Schmid added that lasers used in toys will generally be labeled as Class 1, although he said that products aren't always labeled properly.

And, even if you've purchased a "safe" laser toy, it's possible that creative children may turn to the Internet and figure out ways to boost the power of the laser. "By searching YouTube for 'burning laser pointers,' you will find a huge amount of videos showing such dangerous experiments. Moreover, there is an increasing number of homepages and videos demonstrating how to turn legal low-power lasers into burning, high-power lasers," said Schmid.