Two Patients With Macular Degeneration Get Artificial Retinas

LYON, France — A 72-year-old woman with dry age-related macular degeneration (AMD) was the first patient to receive an artificial retina implant as part of the multicenter PRIMAvera clinical trial, which is looking at the safety and efficacy of the PRIMA system.

“Her vision was severely impaired by this condition. We used the ETDRS chart to assess her visual acuity, as this is the current method in ophthalmology. She was able to read only nine letters,” said Laurent Kodjikian, MD, PhD, from Hôpital de la Croix-Rousse in Lyon, who is a former president of the French Society of Ophthalmology. To put that in perspective, a person with normal vision can make out 85 letters, he explained.

“The goal is to get her reading another ten letters,” he told Medscape Medical News.

The hospital where Kodjikian works is one of six centers in France selected to take part in the ongoing AMD clinical trial; other study sites are in Germany, Italy, the Netherlands, and Spain. The 38 study participants will be followed for 12 months after implantation to assess visual acuity and adverse events, and outcomes will be monitored for 3 years. Investigators hope that the findings will lead to the device receiving authorization to enter the market.

The PRIMA artificial retina system has three elements: a tiny wireless retinal implant; a pair of glasses with a camera and digital projector; and a portable processor connected to the projector. The camera captures visual scenes from the surrounding environment. The processor uses algorithms to process and simplify the images, which are then sent back to the glasses. The digital projector uses pulses of infrared light to project the processed images onto the retinal implant’s photovoltaic receptors. These receptors then convert the optical information into electrical stimulation, which excites the nerve cells of the inner retina, allowing them take in the information and transmit it, via the optic nerve, to the brain. This then induces visual perception.

A Delicate Operation

To implant the chip, Kodjikian made a rather large incision — 3.5 mm — and then peeled off the retina, all while looking through a surgical microscope.

“It’s easy to peel off the retina in a healthy eye. However, the procedure becomes more difficult in an eye affected by dry AMD, where the retina tissue is not only very thin and firmly attached to the back wall of the eye, but is also very fragile. A lot can go wrong during this step, so we have to really take our time,” he said. “You can’t go too deep, and if you go too close to the surface, you risk perforating the retina. Like walking on a very thin tightrope, there’s danger all around, and very little room for error.”

After the chip was inserted under the retina, Kodjikian put the retina tissue back into place. “This was the first time I’d ever done this kind of procedure, and it was quite a challenge,” he told Medscape.

The operation took 2.5 hours, which is much less time than the 4 to 5 hours estimated by the manufacturer.

The patient will undergo rehabilitation for 12 months to help her adapt to the system. “Our hope is that this patient will be able to see better with the implant. She probably won’t get to the point of being able to drive a car. And while reading novels in small print may not be possible, it’s quite likely that she’ll be able to read large-print editions,” Kodjikian explained.

Upon activation of the retinal prosthetic, the patient experienced visual impressions that she couldn’t see before the surgery. And 1 month after the procedure, things seem to be on track, according to a press release. “The postoperative result is excellent. There are no complications, the chip is perfectly in place and the vision has not been degraded by the operation. She should now start to improve thanks to rehabilitation,” said Kodjikian.

“Of the various artificial retina systems out there, this one is the most sophisticated because it has the most pixels. The technology will certainly continue to advance. But for the time being, the clinical study should allow us to show that it does work,” he concluded.

In December 2021, he implanted an artificial retina in a second patient, and it took him 50 minutes less than the first one.

This article originally appeared in the French edition of Medscape.

The authors have disclosed no relevant financial relationships.

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Leading causes of broken eyeglasses

After years of working with patients and their broken glasses, my experience has been:

  • Glasses were sat on (usually when put down on a bed while dressing/undressing), or stepped on.
  • Glasses were damaged during a sports or recreational activity.
  • Glasses were “altered” by a family pet…almost always a dog.
  • Glasses were destroyed by a young child. Could be the child’s or the parent’s glasses.
  • Glasses were damaged in luggage, backpack,etc.
  • Glasses were damaged by owner while attempting to do a repair at home.
  • Glasses were damaged by “unknown entity.” Were found destroyed on nightstand upon wakening. “They must have been defective.”
  • Georgio Armani eyeglassesGeorgia Armani eyeglasses t2

Please note that I am not counting loose or missing screws, broken nylon cords for rimless. missing nose pads or temple tips. Those parts are easily fixed and do not constitute damage. Also, home repairs using super glue, toothpicks, standard solder, epoxy resin, acetone, etc. will elevate a low level repair to the need for frame replacement, and will void manufacturers warranties.

Anti reflective lenses

Glasses with anti-reflective coating have grown in popularity as more jobs demand that employees spend time behind a computer. Everyday use of smartphones, TV viewing, and other gadgets with screens can strain the eyes even further.

In the past, AR coating was a nuisance because it would easily peel off, scratch, and get dirty easily. Today’s AR-coated lenses have improved. Their anti-reflective capabilities are “seared” into the lens.

Anti-reflective coating, also called AR coating, is created to:

  • Block UV rays to enhance eye protection.
  • Block blue light, which can help with eye strain, blurry vision, and dry eyes.
  • Resist smudges and scratches.
  • Stop water damage.

Brands such as Crizal are major purveyors of these lenses. They specialize in lenses for children and have a variety of lenses with these features. Some of their offerings are expensive.

In addition to helping you see better, AR-coated glasses are more aesthetically pleasing if you are a person who is often photographed. They let light enter more easily, allowing people to see your eyes better beneath your lenses.

Corneal Arcus or Arcus Senilis

Eyes are often considered the “window into the soul,” but in eye care they are more commonly used as a window into the patient’s overall health. Eyes can change in many ways as you get older, but some of these changes can indicate other health issues you otherwise might not notice.

Systemic diseases like diabetes and conditions like high blood pressure can all be detected during a comprehensive eye exam, but what can corneal arcus tell you about your health?

Today, we’re going to unpack this little white outline of your cornea and look at what this condition is, how common it is, and what it could mean to your overall health.

What is Corneal Arcus?

Corneal arcus, otherwise known as arcus senilis for seniors or arcus juvenilis for those under 40, is typically an age-related condition that creates a deposit of cholesterol, phospholipids, and triglycerides in an “arc” on either the top or bottom side of the iris, inside the cornea. Over time, the arc can grow to encircle the entire iris, creating a white, gray, blue, or yellowish “outline.”

Corneal arcus can indicate a variety of different health concerns, including high blood pressure, high cholesterol, and atherosclerosis. This connection was discovered as early as 1852, when pathologist Rudolf Virchow suggested that there was a connection between corneal arcus and atherosclerosis. This was a controversial topic of discussion for many years, but recent studies have shown that his hypothesis may be correct.

However, despite the physical appearance it may have on the eye, corneal arcus should not affect vision.

How Does it Develop?

This condition usually develops with age and can be found in nearly 60% of individuals between 50 and 60 years of age, but that percentage climbs to nearly 100% in patients 80 years old and older.

Corneal arcus is generally caused by lipid deposits developing on the cornea’s edge, typically related to a slowdown in lipid metabolism as the patient grows older. However, if it develops in a patient younger than 40, it could implicate a more serious situation.

How Does it Affect Your Vision and Health?

If corneal arcus develops as a result of aging, it is usually not a cause for concern. However, in individuals younger than 40, corneal arcus could indicate higher than normal cholesterol or triglyceride levels.

Higher cholesterol and triglyceride levels could indicate an increased risk of cardiovascular disease and stroke.

Corneal arcus isn't usually a cause for concern, but it could indicate more serious health problems.

What Should You Do?

There is no cure for corneal arcus, as the condition itself isn’t actually harmful to your eyes or eye health. However, if you notice a white, yellow, gray, or blue ring or outline forming around your iris, you should visit your optometrist for an eye exam. Your optometrist can help you determine if your symptoms are benign or if they indicate a larger issue developing.

You may also be recommended to have your blood checked for abnormal levels of cholesterol and triglyceride. Your doctor may recommend lifestyle changes like diet and exercise. Some patients have decided to look into corneal tattooing to cover up the arc, but this is not recommended or encouraged by the medical community.

If you’ve noticed a symptom similar to corneal arcus in your eyes, with us today and we can help you determine what’s best for you and your health!

After 40 years of blindness, injection of light-sensitive protein restores a man’s vision

The first successful clinical test of a technique called optogenetics has allowed a 58-year-old man to see for the first time in decades.

The man was able to see with the help of image-enhancing goggles after 40 years of blindness, thanks to an injection of light-sensitive proteins into his retina.

According to a study published by Nature Medicine on May 24, this is the first successful clinical application of optogenetics, a technique in which flashes of light are used to control gene expression and neuron firing.

The study revealed that the technique is widely used in laboratories to probe neural circuitry and is being investigated as a potential treatment for pain, blindness and brain disorders.

The clinical trial, run by the company GenSight Biologics, based in Paris, enrolls people with retinitis pigmentosa — a degenerative disease that kills off the eye’s photoreceptor cells, which are the first step in the visual pathway.

In a healthy retina, photoreceptors detect light and send electrical signals to retinal ganglion cells, which then transmit the signal to the brain.

GenSight’s optogenetic therapy skips the damaged photoreceptor cells entirely by using a virus to deliver light-sensitive bacterial proteins into the RGCs, allowing them to detect images directly.

GenSight is one of several companies developing optogenetics as a treatment for RP and other disorders of the retina.

In March, Nirenberg’s company Bionic Sight announced that four of the five people with RP it had treated with a similar optogenetic therapy and a virtual-reality headset had recovered some level of vision, although the full trial results have not yet been published.

Also, Swiss pharma giant Novartis is developing a therapy based on a different protein that is so light-sensitive that goggles might not be needed. That therapy has not yet entered clinical trials.

The researchers injected the virus into the eye of a man with RP, then waited four months for protein production by the RGCs to stabilise before testing his vision, the Nature Medicine reported.

José-Alain Sahel, an ophthalmologist at the University of Pittsburgh Medical Center in Pennsylvania and leader of the study, says that one of the challenges was regulating the amount and type of light entering the eye, because a healthy retina uses a variety of cells and light-sensitive proteins to see a wide range of light.

“No protein can replicate what the system can do,” he says. So the researchers engineered a set of goggles that captured the visual information around the man and optimised it for detection by the bacterial proteins.

Using a camera, the goggles analyse changes in contrast and brightness and convert them in real-time into what Sahel describes as a ‘starry sky’ of amber-coloured dots. When the light from these dots enters a person’s eye, it activates the proteins and causes the RGCs to send a signal to the brain, which then resolves these patterns into an image.

The trial participant had to train with the goggles for several months before his brain adjusted to interpret the dots correctly. “He was like an experimentalist, a scientist trying to understand what he was seeing and make sense of it,” Sahel says.

Eventually, he was able to make out high-contrast images, including objects on a table and the white stripes in a crosswalk. When the researchers recorded his brain activity, they found that his visual cortex reacted to the image in the same way as it would have if he had normal sight.

The man still can’t see without the goggles, but Sahel says that he wears them for several hours per day and that his vision has continued to improve in the two years since his injection.

Sahel says six other people were injected with the same light-sensitive proteins last year, but the COVID-19 pandemic delayed their training with the goggles.

A neurobiologist at the University of California, John Flannery says the study “is a big step for the field.

“The most important thing is that it seems to be safe and permanent, which is really encouraging.”

Flannery said while the image may never be as good as natural vision, it is exciting that the brain can interpret images accurately.

Other researchers are, however, calling for more studies.

Sheila Nirenberg, a neuroscientist at Weill Cornell Medical College in New York City says she looks forward to seeing whether the other people in the trial, including some who were injected with higher doses of the protein, have similar results.

“It’s interesting, but it’s an N of 1,” she says.

Karl Deisseroth, a neuroscientist at Stanford University in California who co-developed optogenetics as a lab technique, says the study is important because it is the first time that the technique’s effects have been shown in people.

“It will be interesting to try this with more light-sensitive opsins” that might not require goggles, he says. But he expects optogenetics to be most useful as a research tool that leads to therapies, rather than a therapy itself.

“What we hope to see even more of is optogenetics-guided human and clinical studies,” he says.

How to maintain health eyes

Good vision helps you perform well—at home, at work, or behind the wheel. That’s why it’s important to take a few simple steps to make sure you help keep your eyesight at its best. A regular eye exam is the best way to protect your eyesight – and an easy precaution to take. Here are some tips to help maintain eye health as you age.

Eat a Balanced Diet

fruit vegetablesAs part of your healthy diet, choose foods rich in antioxidants, like Vitamins A and C; foods like leafy, green vegetables and fish.  Many foods – especially fatty fish, such as salmon – contain essential omega-3 fatty acids that are important to the health of the macula, the part of the eye responsible for central vision.

An inadequate intake of antioxidants, consumption of alcohol or saturated fats may create free-radical reactions that can harm the macula – the central part of the retina. High-fat diets can also cause deposits that constrict blood flow in the arteries. The eyes are especially sensitive to this, given the small size of the blood vessels that feed them.

Your eyes are unique, and have their own set of nutritional needs. Ocuvite eye vitamins are specially designed to provide a balanced combination of nutrients dedicated to the health of your eyes.* Visit Ocuvite.com to learn more.

Exercise

Exercise improves blood circulation, which improves oxygen levels to the eyes and the removal of toxins.

Get a good night’s sleep

You’ll feel the difference when you get the sleep you need. You’ll look great, you’ll perform at home or work—and good rest will support the health of your eyes.

Wash your hands

Keeping your hands clean is so important when it comes to your eyes, especially if you’re a contact lens wearer. Before you touch your eye—and before you put in or remove a contact lens—wash your hands with a mild soap and dry with a lint-free towel. Some germs and bacteria that come from your hands can cause eye infections, like bacterial conjunctivitis (pink eye). When you touch your eye, whatever is on your fingers goes right onto your eye’s surface. This is one way that people catch colds—rubbing their eyes while they have cold virus germs on their hands.

Don’t Smoke

Smoking exposes your eyes to high levels of oxidative stress. While the connection has not been clearly identified, it is known that smoking increases your risk for a variety of health conditions affecting the eye. To help you quit, visit the American Lung Association’s free online smoking cessation program – Freedom From Smoking Online – at www.ffsonline.org.

Wear Sunglasses

To protect your eyes from harmful ultraviolet (UV) light, choose sunglasses with both UVA and UVB protection. Also, wearing a hat with a brim will greatly reduce the amount of UV radiation slipping around the side of your sunglasses.

Devices and Blue Light

You’re probably using digital devices for hours each day at work and at home. These devices are exposing your eyes to high energy blue light. It’s called blue light because the wavelengths emitted are near the bluer part of the spectrum. Lutein & Zeaxanthin are eye nutrients that are concentrated in the macula and help eyes filter blue light.* Lutein and Zeaxanthin cannot be produced by our bodies on their own, so they must be obtained through diet and/or supplements. If you don’t think you’re getting enough in your diet, visit Ocuvite.com to learn more. 

Here are some other tips to help when you’re on your computer:

  • Keep your computer screen within 20″-24″ of your eye.
  • Keep the top of your computer screen slightly below eye level.
  • Adjust lighting to minimize glare on the screen.
  • Blink frequently.
  • Take a break every 20 minutes to focus on an object 20 feet away for 20 seconds.
  • Use lubricating eye drops to soothe irritated, dry eyes.

Glare Reducing Lenses: Understanding Their Uses

Glare Reducing Lenses: Understanding Their Uses

There are two main types of glare reducing lenses for eyewear: lenses with an anti-reflective coating and polarized lenses. Both help to prevent glare in their own way. Glare reducing lenses can improve vision clarity, help people see better while driving at night, reduce annoying glare from water or other horizontal surfaces, and eliminate noticeable reflections on a lens itself.

What is glare?

Glare is caused by light bouncing off of a reflective surface. When talking about eyewear, people are most likely referring to lens glare or environmental glare. Lens glare is caused by the reflection of light off the surface of a lens. Whether it belongs to a camera, telescope, binoculars, or even just glasses, all lenses have some level of reflection with the lowest amount of reflection being less than 0.1%. Eyeglass lenses without a glare-reducing coating typically allow around 90% of light to pass through, depending on the lens material. The other 10% of the light reflects off the surfaces of the lens. The glare caused by this 10% reduces vision clarity, causes people to see halos around headlights and street lamps at night, and creates bright, almost white reflections on the lens itself.

Environmental glare is caused by light waves reflecting off of flat surfaces like water or the highway. It becomes focused and travels in a uniform direction parallel to that surface, creating a bright and intense reflection that we call glare. This type of glare affects everyone, regardless of whether or not they wear glasses.

glare reducing lenses

Outline, in Black

How do glare reducing lenses work?

While it may be impossible to eliminate 100% of the glare on glasses lens, technology has helped to get the number as close to 0 as possible. While both anti-reflective coatings and polarized lenses help to reduce glare, the technology behind these two is quite different. An anti-reflective coating (also known as AR or anti-glare coating) actually encourages more light to pass through a lens. When more light passes through, less light reflected off its surfaces, and thus, less glare.

Polarized lenses, on the other hand, reduce glare by absorbing light waves from a certain orientation. Most polarized lenses for eyewear are oriented to absorb horizontal light waves reflected off of flat surfaces like a lake or the snow-covered ground.

When it comes to eyewear, AR coatings are applied both eyeglass lenses and sunglass lenses. Anti-glare coating is applied to both sides of a lens to prevent light from reflecting off the back of the lens as well. Polarized lenses are typically used for sunglasses since the nature of its glare reducing technology is to block light instead of letting more through.

The benefits of glare reducing lenses

Many people question whether or not it’s worth it to get glare reducing lenses. The short answer is: while not everyone may need sunglasses with polarized lenses, lenses with an anti-reflective coating will vastly improve the quality of life for a glasses wearer.

Lens glare is a major source of eye strain since it reduces vision clarity, forcing your eyes to work harder to focus. People who work with computers are especially susceptible to this type of eye strain since illuminated screens act as a direct and constant source of glare on lenses. Adding AR coating to your lenses significantly lessens this glare, helps you see more clearly, and reduces eye strain caused by computer screens.

Glares called “halos” can be seen around the headlights of cars and street lamps. These halosare a great source of discomfort and distraction for glasses wearers who drive at night. They reduce visibility and make nighttime driving difficult. Anti-glare coating prevents these halos and helps to make driving at night safer for glasses wearers.

If you’re someone who is both literally and figuratively in the spotlight a lot, anti-reflective coating is a must. Glare caused by bright lights reflecting off a lens can be distracting. It also obscures your eyes, making it harder for people to find direct eye contact with you. So if you have a client- or customer-facing job, make sure to consider getting glare reducing glasses.

Finally, if you’re someone who spends a lot of time out on the water or working in the snow, you’re well aware of how much glare can reduce visibility and make it a literal pain to be outside. The tint on sunglasses with polarized lenses helps to reduce that all around brightness, while the polarization helps to save your eyes from blinding glare.

So for the best comfort while wearing glasses or sunglasses, consider glare reducing lenses. Not only will they help you see better, but they’ll also help you get the most out of life. At EyeBuyDirect, you can find affordable glare reducing lenses for any of our great styles.

Coined from eyebuydirect.com