Scripps Health - All News for Eye Care

Artificial Eye Implant Developed from Rare Coral Becomes Part of Body

2011-12-08T12:27:50-08:00

Ron Remsberg received a Bio-Eye, an artificial eye that is designed to look and move like a real eye. The porous coral it’s made of allows blood vessels to grow into the implant.

Learn more about how Scripps is transforming medicine.

Looking at the Facts About Cataracts

2008-03-19T21:09:34-07:00

by Matthew Kirk, M.D., Scripps Memorial Hospital La Jolla

It’s a fact: Aging isn’t kind to your eyes. Just when you get used to your reading glasses and bifocals, another potential vision problem may be waiting in the wings: cataracts.

A cataract affects the lens in your eye that focuses light on the retina. In a normal eye, light passes through the clear lens to the retina, where it becomes nerve signals that are sent to the brain to create visual images.

In order for the images to be clear, the lens must be clear. A cataract affects the proteins in the lens, causing it to cloud. As a result, you may experience decreased or blurry vision in one or both eyes. You may see glare or halos around lights, or have trouble with your night vision, especially while driving.

At first, a cataract may cloud only part of the lens. Over time, it may worsen, and vision loss gradually becomes more noticeable. The clear lens slowly becomes yellowed and vision can take on a brownish tint. Eventually, it may become difficult to distinguish between colors, especially blues and black.

What causes cataracts?

Age is the main factor behind most cataracts. They usually start to develop after age 50; by age 60, vision changes become more apparent. By age 80, more than half of all Americans have a cataract or have had cataract surgery. Other causes of cataracts, especially in younger patients, may include smoking, diabetes, uveitis (inflammation of the eye), trauma from an injury to the eye, or extensive exposure to UV rays from the sun. Family history may also play a role.

A cataract can develop in one eye or both, but it cannot spread from one eye to the other. If you develop cataracts in both eyes, chances are one eye will be more advanced.

How are cataracts treated?

The first step in treating cataracts is a thorough exam by an ophthalmologist to rule out other causes of decreased vision such as infection, macular degeneration, glaucoma, dry eyes or simply needing a new prescription for glasses or contact lenses.

Once a cataract has been confirmed, the ophthalmologist will grade its clarity to determine the proper course of action. Vision loss caused by cataracts in their earliest stages may be restored with eyeglasses, anti-glare sunglasses or improved lighting. If a cataract significantly impairs vision and interferes with daily activities such as driving or reading, surgery may be the only effective treatment.

Cataract surgery is an outpatient procedure that can be done in the operating room or surgery center under local anesthesia. During surgery, your ophthalmologist will remove the cloudy lens and replace it with a clear artificial lens called an intraocular lens. The procedure itself takes less than 30 minutes in most cases. If you have cataracts in both eyes, your ophthalmologist will typically do one eye first, and the other eye a few weeks later.

In recent years, there have been many technological advances in the intraocular lenses used in cataract surgery. Some of the newer lenses not only replace the old lens but can also reduce your need for reading glasses or help treat astigmatism, which is blurred vision caused by an irregularly shaped cornea.

Can cataracts be prevented?

While you can’t stop the effects of aging on your eyes, you can make lifestyle changes to help prevent cataracts caused by other factors. If you smoke, stop. Limit exposure to intense UV light with quality sunglasses.

Research suggests that good nutrition may also help reduce the risk of cataracts by protecting the lens from the damage caused by chronic exposure to UV light.

If you are age 50 or older, have your eyes examined at least once a year to check for signs of cataracts and other vision disorders. Early diagnosis and treatment may help preserve your vision.

Matthew Kirk, M.D. is an ophthalmologist with Scripps Memorial Hospital La Jolla. To learn more about cataracts or schedule an appointment, call 1-800-SCRIPPS (1-800-727-4777).

New Treatments Show Promise for Macular Degeneration

2008-03-12T20:28:11-07:00

By Anne M. Hanneken, M.D., Scripps Memorial Hospital La Jolla

One of the most promising new treatments for a leading cause of blindness may also be one of the most surprising. A chemotherapy medication commonly used to treat colon cancer is one of the medications being used to treat one type of macular degeneration, an eye disease that is the primary cause of blindness in patients over age 55.

To understand how chemotherapy can treat an eye disease, it helps to understand how macular degeneration produces vision loss.

What Is Macular Degeneration?

Macular degeneration is a disease that affects the portion of the eye known as the macula.The macula surrounds the central part of the retina, which is the inner lining of the eye that absorbs and processes light. The macula helps focus that light for tasks that require close, concentrated vision, such as reading or threading a needle.

In the early stages of macular degeneration, vision loss may be barely perceptible. It may be more difficult to see the squares of a crossword puzzle or read directions on a box, for example. Eventually, nearly all central vision may be lost. However, since the disease doesn’t affect peripheral vision, complete loss of vision is rare.

“Dry” vs. “Wet”

There are two forms of macular degeneration. Both begin with a build-up of small protein deposits under the cells that nourish the retina; these deposits cause no symptoms and patients may not be aware of them until they have their eyes examined.

As the condition progresses, the cells that nourish the retina begin to deteriorate. In this “dry” form of macular degeneration, vision loss progresses slowly, so central vision can remain stable for years. “Dry” macular degeneration accounts for up to 90% of cases.

In the remaining 10%, however, vision may change suddenly, with marked distortions and wavy lines. This signals the development of abnormal blood vessels which grow under the retina and cause severe scarring around the cells that nourish it.This “wet” form of macular degeneration is recognized by the appearance of blood and scar tissue under the retina. The chemotherapy drug, Avastin, inhibits the growth of these blood vessels and can restore vision in patients with “wet” macular degeneration.

Avastin is the standard of care for patients with colon cancer; because it inhibits blood vessel growthin colon cancer tumors, ophthalmologists began using Avastin “off-label” (outside the scope of its approved usage) to treat macular degeneration patients. About a year later, the company that made Avastin released Lucentis, a non-chemotherapy form of Avastin which was then FDA-approved for macular degeneration treatment. Patients who have been treated with injections of Lucentis or Avastin have seen dramatic results; some legally blind patients have regained enough vision to read again. Treatment may need to be repeated in order to maintain the positive effects.

While there is currently no treatment for the “dry” form of macular degeneration, recent clinical research has suggested that certain nutrients may help reduce its progression.

The Age-Related Eye Disease Study (AREDS), a large, 10-year clinical trial sponsored by the National Eye Institute, suggested that multi-vitamins, antioxidants, copper and zinc could reduce progression by up to 30% over a five-year period.In another study, patients who ate three servings of spinach per week had a 43% lower risk of developing macular degeneration.Diets high in antioxidant carotenoids, colored pigments normally present in the macula which serve as a kind of protective coating against light damage, are associated with a decreased risk of the disease. Lutein and zeaxanthin are two such carotenoids.

Flavonoids, another group of natural antioxidants present in a wide range of fruits and vegetables, also are being studied as potential beneficial nutrients for the prevention of macular degeneration.Flavonoids evolved to protect plants from the oxidative damage induced by chronic exposure to ultraviolet light.They are believed to have many health benefits, including protection from cardiovascular disease and cancer.

In a collaborative effort between The Scripps Research Institute and The Salk Institute, we have been testing a variety of nutritional flavonoids to identify which specific compounds protect cells from the type of injury which leads to macular degeneration. Based on our early findings, we have compiled a list of fruits and vegetables with the highest concentrations of flavonoids found to be most effective. These vegetables include spinach, wild greens, onions (especially yellow), tomatoes, celery, hot peppers and chives. Among fruits, cranberries, cherries, blueberries, strawberries, kiwi, grapes, apples and citrus juices may be good choices.

Anne M. Hanneken, M.D. is an ophthalmologist with Scripps Memorial Hospital La Jolla. Join Dr. Hanneken for a free seminar on macular degeneration on Friday, March 14, at 10 a.m. at the Schaetzel Center on the hospital campus. To register, please call 1-800-SCRIPPS (1-800-727-4777).