Dr. Grossman’s Blog

Image courtesy of US Gov.

The word presbyopia is derived from Latin, and means “old eyes.” Presbyopia is a vision condition that occurs when the crystalline lens of your eye loses its flexibility, which makes it difficult for you to focus on close objects.

Research focused on individuals in the developing world is showing that presbyopia affects men and women at different ages and in different ways.

A number of studies have revealed that women are more likely to suffer from presbyopia across the world – in Ghana, India, and Brazil.  Due to economics, women are also less likely to be able to obtain glasses than men.  For example, in a study of people with presbyopia in Tanzania, only 6% with the condition had glasses and nearly all of those were men.

While this condition is often associated with difficulties associated with reading and writing, in many parts of the world presbyopia interferes with other essential daily tasks like “lighting and adjusting lamps, winnowing grain, sorting rice, weeding, sewing, cooking food, and dressing children.”

Source: Community Eye Health Journal

If you would like to work to prevent presbyopia naturally, please visit our website.

Image by Microsoft

Vitamin A deficiency is uncommon in the U.S., but it affects many people in the developing world.  One of first symptoms of a vitamin A deficiency is night blindness, which, if untreated can develop into full scale blindness.  According to the World Health Organization Report on Vitamin A Deficiency, night blindness is estimated to affect 5.2 million preschool-age children and 9.8 million pregnant women around the globe.

Writing on a recent case in The Lancet, doctors who treated a pregnant woman who came to the emergency room after several weeks of progressive sight loss described this particular case, “Vitamin A deficiency can be secondary to poor intestinal absorption due to weight loss surgery, Crohn’s disease or pancreatic dysfunction. Our patient had anorexia nervosa and had limited her diet to white onions, white potatoes, and red meat for the past 7 years.”

We usually recommend taking vitamin A in the form of beta-carotene, which converts to vitamin A with a small amount of fat in the diet. Food sources of vitamin A include: yellow and orange vegetables (including yams, carrots, mangoes, cantaloupe, apricots, butternut squash,and sweet potatoes), and asparagus, spinach, kale, bok choy.  If you wish for additional supplementation, the recommended dose is approximately 15,000 to 25,000 I.U. of beta-carotene daily.

Learn more about food as sources of vital nutrients at our website.

Although individuals with age-related macular degeneration (AMD) lose central vision, their peripheral vision often remains intact.   The Macular Disease Society (based in the UK) has developed a training scheme to help people use the undamaged parts of their eyes to read and identify faces. 

According to their research, people can be taught to use their peripheral vision to compensate for damage to their central vision, using “eccentric viewing” and “steady eye techniques”.   When someone with central vision loss looks directly at an object it may disappear or appear distorted, but when they look above, below, or to one side of it, they see it more clearly.

Eccentric viewing helps people learn where to focus their gaze to make their vision better.  Once this position is identified, they can be taught how to read again using the steady eye technique:  instead of moving the eyes from left to right to read a sentence, the person can keep their eyes completely still and move the text to the left so that each word in turn moves into the area of best vision.

Learn more about macular degeneration

SOURCE:  BBC News Channel, April 10, 2009, http://news.bbc.co.uk/1/hi/health/7958838.stm

Hemianopia is a blindness in one half of the visual field due to damage of the optic pathways in the brain. This damage can result from brain injuries caused by stroke, tumor or trauma.  A patient with hemianopia may be unaware of what he or she cannot see and may frequently bump into walls, trip over objects or walk into people on the side in which the visual field is missing.

Prism eyeglasses were invented by Dr. Eli Peli of the Schepens Eye Research Institute, an affiliate of Harvard Medical School, to assist patients with hemianopia.  Dr. Peli attached small high power prisms on the top and bottom of one spectacle lens, leaving the center of the lens untouched. The prisms pull in images missing from the visual field above and below the line of sight on the side of the vision loss.  The prisms alert the patient to the presence of a potential obstacle, so that the patient can then move his/her head and eyes to examine the prism-captured image directly through the clear center of the lens.

In the trial, 32 of 43 participants (74%) who were fitted with prism glasses continued wearing the glasses at week six; at 12 months, 20 (47%) were still wearing the spectacles eight hours daily and rating them as “very helpful” for obstacle avoidance.

A larger study is currently underway to evaluate a newer model of the eyeglasses. 

SOURCE: “Community-Based Trial of a Peripheral Prism Visual Field Expansion Device for Hemianopia”, Bowers, et al, Archives of Ophthalmology, 2008, vol. 126, no5, pp. 657-664.

Regular Eye Exams are Vital for Driver Safety

11 million Americans with could be driving with uncorrected vision problems. Depending on where those drivers live, their last DMV-required vision screening could have been eighteen years ago; some may never have had one at all, according to a report by the Vision Council of America (VCA). 

“Our already crowded roads are made that much more dangerous by drivers with uncorrected vision problems getting behind the wheel,” said Ed Greene, VCA chief executive officer. “Since 85 percent of the information needed for safe driving is visual, regular eye exams are an important part of driver safety.”

The VCA report “Keeping Our Eyes on the Road,” reviewed vision screening laws and found them to be inconsistent. While some states require vision screenings every time drivers renew their licenses, other drivers may go as long as 18 years before they are required to have their vision re-checked. Nine states require no vision screening at all for license renewal. In the absence of standards for vision screenings, drivers must be responsible for maintaining good vision.

“We rely on our eyes every time we step into a car; especially our peripheral vision, depth perception and focusing skills,” said Greene.  “This link between vision and driving makes it essential for motorists to take steps to maintain healthy vision, just as they take other safety precautions on the road.”

“People often don’t notice gradual changes in their vision which, over time, can impede their ability to drive safely,” said ophthalmologist Elaine G. Hathaway, M.D. “Checking your eyes is important not only to determine proper vision correction, but also to detect cataracts and sight-threatening diseases such as glaucoma and macular degeneration so they can be properly treated.”

VCA suggests the following tips to help drivers stay safe on the roads:

• Take breaks when driving long distances to reduce eye strain and fatigue
• Use sunglasses with at least 99 percent UV protection when appropriate
• Investigate anti-reflective or polarized lenses to allow more light to enter the eye and to minimize glare
• Keep headlights, taillights and windshield (both inside and outside) clean
• Receive regular eye exams by an eye care professional to ensure that your eyes stay healthy and your prescription remains current

Regardless of what your state requires, VCA recommends that drivers receive a regular comprehensive eye exam by an eye care professional to maintain healthy vision.  With regular vision care, drivers can prevent poor sight from putting themselves and their loved ones at risk on the road.

SOURCE:  Vision Council of America, Keeping Our Eyes on the Road, November 19, 2007.

A new study has found that common vision problems known as refractive errors (nearsightedness, farsightedness, and astigmatism) affect half the adult U.S population.

The study authors, led by Susan Vitale of the U.S. National Eye Institute, analyzed data collected by the U.S. Centers for Disease Control and Prevention’s ongoing National Health and Nutrition Examination Survey. In this study an autorefractor was used to obtain refractive error data on a nationally representative sample of 12,010 adults in the U.S. population between 1999 and 2004.

Of the participants (all aged 20 or older), researchers found:

• 3.6% had hyperopia (farsightedness),
• 33.1% had myopia (nearsightedness), and
• 36.1% had astigmatism (an irregular corneal curve)

Other findings:

It’s no surprise that failing eyesight leads to more accidents, but a new study shows early intervention to correct even minor visual impairment may prevent injury.

Decreased vision in older people is commonly related to an increased risk of falling, and a new study has scientifically evaluated this link. The goal of the study was to determine whether visual loss was associated with a higher incidence of injurious accidents and whether walking speed or physical activity influenced this association.

416 people aged 75 to 80 years were tested for visual acuity. Those testing at less than 20/60 in the better eye (with spectacle correction when necessary) were defined as visually impaired. Those tested with visual acuity between 20/60 and 20/40 were defined as having lowered vision. Those testing at greater than 20/40 were defined as having normal visual acuity.

Hospital records of accidents with injuries were monitored for ten years, during which 239 participants (58%) suffered at least one injurious accident. Even considering other factors (age, gender, eye-related diseases, diabetes and cardiovascular diseases), the risk of injurious accidents for participants with lowered vision was 1.45 compared with those with normal visual acuity.

Interestingly, participants with visual impairment did not have an increased risk for accidents over those with lowered vision, and neither walking speed nor physical activity had a mediating effect on the relationship between visual loss and accidents.

Researchers have therefore concluded that lowered vision is a risk factor for accidents in older people independent of mobility and physical activity.

In light of this research, early intervention strategies such as proper correction of vision or cataract extraction are truly important in preventing accidents in the elderly.

Read more about vision loss prevention

SOURCE: Kulmala J, Era P, Parssinen O, et al. Lowered vision as a risk factor for injurious accidents in older people. Aging Clin Exp Res 2008;20(1):25-30.

NATIONAL EYE INSTITUTE (NEI) SURVEY: Most Americans do not know the risks and warning signs of diseases that could cause blindness without timely detection and treatment, according to recent findings of the Survey of Public Knowledge, Attitudes, and Practices Related to Eye Health and Disease, sponsored by the National Eye Institute and the Lions Clubs International Foundation.

More than 3,000 adults were selected randomly to participate in a national telephone survey conducted between October 2005 and January 2006. Seventy-one percent of respondents reported that a loss of their eyesight would rate as a 10 on a scale of 1 to 10 (meaning that it would have the greatest impact on their day-to-day life); however, only eight percent knew that there are no early warning signs of glaucoma.

Fifty-one percent were aware that people with diabetes are at increased risk of developing eye disease, but only 11 percent knew that there are usually no early warning signs of diabetes-associated eye disease. Only 16 percent had ever heard the term “low vision.” Hispanic respondents reported the lowest access to eye health information and knew the least about eye health; they were also the least likely to have their eyes examined among all racial/ethnic groups in the survey.

NEI plans to use the survey results to raise public awareness of eye disease and the importance of early detection and treatment; it will also expand its educational outreach to Hispanics and increase its efforts to educate healthcare providers on how to communicate with patients about preserving and protecting their vision.

I should mention that there are quite a number of drugs which can harm your eyes – all of the following have the potential to contribute to glaucoma and other vision problems.

• NSAID’s-(non-steroidal anti-inflammatory drugs)include aspirin, ibuprofen (Advil, Motrin, Bayer, Aleve), flurbiprofen, ketoprofen and naproxen sodium. Also Tylenol (acetaminophen), though not an NSAID, can be harmful.
• Venlafaxine
• Steroids – cortisone prescriptions such as Prednisone are the most damaging drugs to the eyes of any prescription drugs. If you must take any of these drugs, be sure to supplement your diet with anti-oxidants such as vitamins E and C, and beta-carotene. Ask your doctor if you can replace Prednisone with a natural cortisone such as hydrocortisone.
• Simvastatin
• Fenfluramine
• Mirtazapine
• Gastic antispasmodics
• Antidepressants

A much safer course than automatically taking a lot of drugs, ie, for a headache, is to look at other contributing factors and make lifestyle changes in the amount of rest you get, the amount of exercise you get, your diet, levels of stress in your life, and so forth.

What are the conventional treatment options for glaucoma? Do they work?

Treatment depends on the nature and severity of each case. Commonly, open angle glaucoma is treated with eyedrops or oral medications. In the event this treatment does not lower the eye pressure inside the eye, laser therapy or surgery may be necessary. There are no guarantees!

What about alternative treatment?

Since we consider most eye conditions to be a reflection of the health of the whole body, lifestyle choices and diet can play a major factor in getting and maintaining good vision. Below are some recommendations:

• Studies show patients can reduce their eye pressure by five to seven millimeters with an improved diet and supplement program. In general, a diet high in betacarotene, vitamins C and E, and sulfur-bearing amino acids are recommended. Foods containing those nutrients include garlic, onions, beans, spinach, celery, turnips, yellow and orange vegetables, green leafy vegetables, seaweed, apples, oranges and tomatoes.
• The Vision Diet – recommended in Natural Eye Care: Your Guide to Healthy Vision, authored by Marc Grossman, O.D., L.Ac. and Michael Edson, MS, L.Ac. This CD covers 29 major eye conditions including Glaucoma with specific nutrient, diet, exercise and juicing instructions by eye condition, plus much more.
• Daily juicing of vegetables and fruits (preferably organic). Our glaucoma recipe is some combination of the following: celery, carrots, cucumber, radish, turnip, parsley, beets, cabbage, raspberries, plums, apple (not too much fruit). For more information, go to info about juicing.
• Drink lots of water – 8-10 glasses of purified water. Avoid carbonated, caffeinated and alcoholic beverages. They can actually dehydrate your eyes.
• Manage your stress – meditate, take a walk in nature, practice yoga, visualization techniques or prayer on a daily basis.
• Exercise daily – do at least 20 minutes of aerobic exercise daily. Walking and swimming are two excellent forms of exercise.
• Eye exercises can help to bring energy and blood to the eyes, thereby helping to drain away toxins or congestion to the eyes. These are free general eye exercises and acupressure points for overall eye health. See Free Eye Exercises
• Avoid foods to which you are allergic: a study of 113 patients with chronic simple glaucoma showed immediate IOP increases of up to 20 millimeters when they were exposed to foods in to which they were allergic.
• Supplement your diet with a specific eye formula such as the Optic Nerve Formula and an organic green drink daily such as Nanogreens